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PUBLIC   HEALTH 


THE  LOME  PRIZE  ESSAYS 


Award  made  at  the  Thirteenth  Annual  Meeting 


^mmcan  Pttblic  j^taltl)  ^0sonati0n 


WASHINGTON,  D.  C,  DEC.  lo,  1885 


WITH     AN     APPENDIX 


Republican  Press  Association,  22  North  Main  Street 


INTRODUCTION. 


The  four  valuable  papers  which  constitute  this  volume  are  the  result 
of  prizes  offered  by  Mr.  Henry  Lomb,  of  Rochester,  N.  Y.,  through  the 
American  Public  Health  Association,  for  the  best  essays  on  the  four  sub- 
jects presented.  This  volume  has  been  prepared  for  the  express  purpose 
of  placing  the  essays  in  a  form  suitable  for  public  and  private  libraries, 
with  a  comprehensive  index.  The  essays  have  also  been  printed  in 
pamphlet  form,  as  will  be  seen  by  reference  to  the  advertisement  on  the 
last  pages  of  this  work. 

That  these  essays  may  be  placed  in  the  hands  of  every  family  in  the 
country  is  the  earnest  desire  of  the  Association,  as  well  as  the  heartfelt 
wish  of  the  public-spirited  and  philanthropic  citizen  whose  unpretentious 
generosity  and  unselfish  devotion  to  the  interests  of  humanity  have  given 
us  these  essays  ;  but  the  financial  inability  of  the  Association  renders  it 
impossible  to  distribute  them  gratuitously ;  therefore,  a  price  covering 
the  cost  has  been  placed  upon  these  publications.  It  is  to  be  hoped, 
however,  that  government  departments,  state  and  local  boards  of  health, 
sanitary  and  benevolent  associations,  etc.,  will  either  publish  these  essays, 
or  purchase  editions  at  cost  of  the  Association,  for  distribution  among 
the  people. 

Although  a  copyright  has  been  placed  upon  these  essays  for  legitimate 
protection,  permission  to  publish  under  certain  conditions  can  be  obtained 
by  addressing  the  Secretary. 


TABLE  OF  CONTENTS. 


I.  Healthy  Homes   and  Food  for  the  Working  Classes.    By  Victor  C. 

Vaughan,  M.  D.,  Ph.  D.,  Professor  in  University  of  Michigan        .        •  •      •      3 

II.  The    Sanitary    Conditions    and    Necessities    of    School-Houses    and 

School-Life.     By  D.  F.  Lincoln,  M.  D.,  Boston,  Mass 65 

III.  Disinfection  and  Individual  Prophylaxis  against  Infectious  Dis- 
E.A.SES.     By  George  M.  Sternberg,  M.  D.,  Major  and  Surgeon  U.  S.  Army.     lor 

IV.  Preventable  Causes  of  Disease,  Injury,  and  Death  in  American 
Manufactories  and  Workshops,  and  the  Best  Means  and  Appliances 
for  Preventing  and  Avoiding  them.  By  George  H.  Ireland,  Spring- 
field, Mass 139 

V.  Appendix 155 


HEALTHY  HOMES  AND  FOODS  FOR  THE  WORKING 

CLASSES. 


By  victor  C.  VAUGHAN,  M.D.,  Ph.D., 

Professor  in   University  of  Michigan. 


HE   WHO   SECURES   A   HEALTHY   HOME    AND    HEALTHY   FOOD   FOR   HIMSELF 
AND   FAMILY   DOES   NOT   LIVE    IN   VAIN. 


Copyright,  1886, 
By  Irving  A.  Watson,  Sec.  American   Public  Health  Association. 


All    Rights    Reserved. 


I. 

BUILDING  A  HOME. 

LOCATION. 

The  location  of  the  home  of  the  working-man  is  often  determined  by 
considerations  over  which  he  has  no  control.  Cost  of  land  and  distance 
from  place  of  labor  must  influence  the  selection.  If  possible,  however, 
the  house  should  not  be  located  in  a  low,  damp  place,  nor  on  made 
earth.  In  cities,  many  low  tracts,  and  even  the  beds  of  small  streams, 
marshes,  and  lakes,  are  filled  in  with  general  refuse,  such  as  street 
sweepings,  back-yard  rubbish,  ashes,  and  garbage.  Such  soil,  unless 
thoroughly  under-drained,  must  be  unfit  for  the  location  of  habitations. 
It  is  damp,  and  will  for  years  be  filled  with  the  products  of  decomposi- 
tion arising  from  the  putrefaction  of  the  garbage  deposited  there.  Houses 
built  in  such  locations  must  be  damp,  musty,  and  unhealthful.  The 
inmates  of  a  house  built  in  such  a  place  are  likely  to  suffer  from  malaria, 
tilious  fever,  and  rheumatism,  even  if  they  do  not  fall  victims  to  the 
more  dreaded  diseases,  typhoid  fever  and  consumption.  The  house 
should  also  be  far  from  marshes  and  other  low  lands,  whose  surface  is 
covered  with  water  in  the  spring  and  early  summer,  and  then  exposed 
later.  Such  situations  are  likely  to  be  malarious.  Neither  should  the 
home  be  located  near  manufacturing  establishments  which  usually  have 
much  garbage  about  them,  such  as  breweries,  tanneries,  glucose  facto- 
ries, rendering  houses,  and  oil  refineries. 

The  site  should  be  one  which  is  naturally  well  drained  ;  and  whether 
this  be  the  case  or  not  often  cannot  be  decided  in  cities  without  consult- 
ing maps  which  show  the  original  lay  of  the  land  before  any  grading 
had  been  resorted  to,  though  the  position  and  course  of  neighboring 
streams  and  the  location  of  springs  may  suggest  valuable  information. 
The  slope  of  the  land  should  be  from  the  house.  Extra  precaution  must 
be  taken  when  it  becomes  necessary  to  build  at  the  foot  of  a  hill  which  is 
covered  with  houses  from  which  the  surface  water  and  under-ground 
drainage  flows  towai'd  the  home.  The  location  of  neighbors'  out-houses, 
•with  reference  to  the  proposed  home,  should  also  be  taken  into  consid- 
eration. While  an  intelligent  man  will  not  neglect  the  sanitary  condition 
of  his  own  premises,  his  neighbor's  cesspool  or  privy  vault  may  drain 
into  his  well  and  poison  his  drinking-water.  Have  the  house  upon  a 
place  high  enough,  and  as  dry  as  possible.  Avoid,  whenever  practica- 
ble, narrow  streets,  which  are  devoid  of  sufficient  sunlight  and  pure  air. 
The  width  of  the  street  should  be  twice  the  height  of  the  houses  along 


4  BUILDING  A  HOME. 

it,  and  no  street,  even  in  the  bvisiness  centres  of  cities,  should  be  naiTower 
than  the  height  of  the  houses.  In  many  of  the  older  cities,  however,  the 
sb"eets  are  narrower  than  this. 

The  best  soils  upon  which  to  build  are  gravel,  marl,  and  limestone  ; 
for  in  these  the  drainage  is  likely  to  be  better  than  in  others. 

A  due  amount  of  shade  around  the  home  renders  it  more  healthy,  but 
the  shade  should  not  be  dense  enough  or  close  enough  to  the  house  to 
obstruct  the  air  and  light. 

THE   CELLAR. 

Every  dwelling-house,  even  that  which  has  but  one  room  in  it,  should 
either  have  a  cellar,  or  should  be  raised  sufficiently  high  from  the  ground 
to  allow  a  free  supply  of  air  under  it.  The  walls  of  the  cellar  should  be 
perfectly  water  and  air  tight.  It  is  better,  in  making  the  excavation,  to 
remove  the  earth  a  foot,  on  all  sides,  further  than  the  line  on  which  the 
outside  of  the  wall  will  stand  ;  then,  after  the  walls  have  been  built,  pack 
the  space  with  clay  or  gravel.  In  this  way  the  walls  of  the  cellar  are 
more  likely  to  be  kept  dry.  If  built  of  brick  the  walls  should  be  hollow, 
consisting  of  a  thin  outer  wall  two  or  three  inches  from  the  main  wall. 
The  two  are  firmly  held  together  by  occasionally  placing  a  brick  across 
from  one  to  the  other  as  the  walls  are  being  built.  Unless  this  is  done, 
moisture  will  pass  through  a  brick  wall,  it  matters  not  how  thick  it  may  be. 

The  cellar  floor  should  be  of  concrete,  about  six  inches  thick,  and 
covered  with  Portland  cement  or  asphalt.  If  the  soil  be  very  damp, 
tiling  should  be  placed  imder  the  cellar  floor,  and  carried  out  beneath 
the  wall  to  a  larger  tile  which  passes  around  the  house  and  leads  off"  into 
some  suitable  receptacle. 

It  is  absolutely  essential  to  a  healthy  house,  that  its  cellar  should  be 
free  from  dampness  and  ground  air.  In  order  to  secure  these  requisites, 
the  walls  and  floor  of  the  cellar  must  be  well  built,  even  if  it  becomes 
necessary,  on  account  of  increased  cost,  to  deprive  the  supersti'ucture  of 
some  of  its  ornamentation. 

The  cellar  should  be  well  supplied  with  light  by  having  windows 
above  ground,  or  by  sunken  areas  in  front  of  the  windows.  The  win- 
dow-sashes should  be  hung  on  hinges,  so  that  they  may  be  easily  opened 
when  the  cellar  needs  an  airing. 

If  the  cellar  is  to  be  used  for  several  purposes,  as  the  location  of  the 
heating  apparatus  and  the  storage  of  fuel  and  vegetables,  it  should  be 
divided  into  compartments,  the  temperature  of  which  may  be  kept  at 
diflerent  degrees. 

Basement  bed-rooms  arc  almost  universally  unhealthy,  and  should  be 
used  only  in  cases  of  absolute  necessity.  It  is  also  best  not  to  have  the 
kitchen  in  the  basement,  especially  if  the  room  directly  above  be  occu- 
pied. If  stationary  wash-tubs  be  placed  in  the  basement,  they  should 
have  a  metallic  or  porcelain  lining,  and  the  pipes  which  conduct  the 
refuse  water  from  them  should  be  thoroughl}'  trapped. 


BUILDING  A  HOME. 


THE  WALLS. 


If  built  of  brick  the  walls  of  the  house  should  be  hollow,  as  described 
in  referring  to  the  walls  of  the  cellar.  Furthermore,  the  plastering  should 
never  be  placed  directly  on  the  brick.  The  inside  of  the  wall  should  be 
"furred,"  scantling  nailed  to  the  furring,  and  the  lathing  done  as  in  a 
frame  house.  It  has  been  found  that  a  single  brick  will  absorb  as  inuch 
as  one  pound  of  water  ;  and  if  a  brick  wall  be  built  solid  and  the  plaster- 
ing placed  directly  on  the  brick,  the  house  will  be  constantly  damp. 
Many  of  the  older  brick  houses  are  constructed  in  this  manner,  and 
consequently  their  interiors  always  have  a  damp,  musty  odor,  it  matters 
not  how  untiring  the  housekeeper  may  be  in  her  efforts  to  have  every- 
thing sweet  and  clean. 

Even  in  case  of  a  stone  wall,  the  plastering  should  not  be  placed 
directly  on  the  wall ;  though  stone  does  not  absorb  water  to  any  such 
extent  as  brick  does. 

New  brick  and  stone  walls  are  necessarily  damp,  and  for  this  reason 
houses  built  of  either  should  not  be  occupied  until  some  weeks  after  the 
building  of  the  walls.  In  order  for  them  to  dry  thoroughly  they  must  be 
perviovis  to  air  ;  and  walls  built  as  recommended  above  will  allow  the  air 
to  pass  through  them  freely.  Plastering  does  not  prevent  the  air  from 
passing  through  the  walls,  but  papering  does.  However,  as  papering  Is 
the  most  economical  way  in  which  walls  can  be  decorated,  It  will  long 
continue  In  use.  Wall  papers  containing  arsenical  colors  have  been,  and 
are  still  to  some  extent,  used.  Rooms  decorated  with  such  papers  are 
not  suitable  for  living  apartments.  It  is  generally  supposed  that  only  the 
green  colors  contain  arsenic,  but.  In  truth,  it  may  be  present  In  paper  of 
any  color.  The  only  way,  then,  by  which  they  may  be  avoided  Is  by 
having  the  selected  samples  tested.  Any  intelligent  druggist  or  chemist 
will  make  the  analysis  for  a  small  fee,  which  should  be  at  the  expense  of 
the  papei'-dealer. 

A  nice  way  of  finishing  inside  walls  is  to  paint  and  then  varnish  them. 
The  varnish  prevents  the  rubbing  off  of  the  paint,  and  places  the  walls  in 
in  such  a  condition  that  they  may  be  washed  whenever  desirable. 

THE    FLOORS. 

Floors  should  be  made  tight,  so  that  they  may  be  thoroughly  scrubbed 
with  soap  and  water  occasionally.  The  best  floor,  from  a  sanitary  view, 
Is  one  of  hard  wood,  planed  smooth,  and  oiled.  It  is  far  better  to  have 
a  clean,  bare  floor,  than  one  covered  with  a  filthy  carpet.  However, 
where  carpets  are  kept  clean,  and  are  occasionally  taken  up  and  the  floor 
scrubbed,  there  is  no  objection  to  their  use  ;  and  It  must  be  admitted 
that  a  clean  carpet  adds  much  to  the  comfort  of  a  room.  A  cheap  straw 
matting  is  now  made,  which  can  be  washed  when  necessary,  and  it  will 
not  retain  dust  and  filth  to  the  extent  that  woollen  carpets  do.  Such  a 
covering  Is  especially  suitable  for  dining-rooms. 


BUILDING  A  HOME. 


ARRANGEMENT    OF    ROOMS. 


The  living-rooms  should  be  on  the  sunny,  airy  side  of  the  house. 
Human  beings  as  well  as  plants  demand  sunlight.  Too  frequently  the 
good  housewife  shuts  out  the  sunlight  for  fear  that  it  will  fade  the  cai-pet. 
As  some  one  has  said,  "It  is  tar  better  to  have  faded  carpets  than  to  have 
faded  cheeks."  A  little  saving  in  the  color  of  the  carpet  is  poor  econ- 
omy when  it  is  secured  at  the  cost  of  health.  Especially  should  the  room 
occupied  by  the  women  and  children,  who  are  indoors  much  of  the  time, 
be  well  supplied  with  light.  If  there  is  to  be  a  long,  dark  hall  or  pas- 
sage-way in  the  house,  let  it  be  on  the  side  upon  which  the  least  sunlight 
falls,  and  place  the  living-rooms  on  the  other  side. 

It  is,  unfortunately,  the  fashion  to  make  bed-rooms  small  in  order  to 
have  a  large  sitting-room.  Too  often  the  bed-room  is  a  mere  recess 
scantily  supplied  with  fresh  air.  It  is  better  to  have  a  smaller  sitting- 
room  and  a  larger  bed-room.  Even  farmers  often  suffer  from  diseases 
which  are  due  to  an  insufficient  supply  of  pure  air.  This  arises  from  the 
fact  that  for  six  or  seven  hours  out  of  every  twenty-four  they  are  shut  up 
in  small,  tight,  musty  bed-rooms,  and  are  compelled  to  rebreathe  the  air 
which  they  have  already  once  breathed: 

As  has  been  said  in  discussing  the  cellar,  basement  bed-rooms  are 
always  poorly  supplied  with  fresh  air,  and  are  generally  damp  and  musty. 
They  should  be  used  only  in  cases  of  absolute  necessity.  Attic  bed-rooms 
are  cold  in  winter  and  hot  in  summer,  and  their  use  also  can  be  excused 
only  on  the  question  of  dire  necessity. 

If  the  owner  of  the  house  can  afford  it,  at  least  one  bed-room  should 
contain  a  grate  or  fire-place, — for,  with  every  attention  to  the  laws  of 
health,  there  will  come  times  when  some  member  of  the  family  will  be 
sick  ;  and  the  sick-room  should  be  full  of  cheer.  The  open  fire  is  cheer- 
ful, and  serves  as  an  excellent  ventilator.  Pleasant  surroundings  oftea 
aid  the  doctor's  pills  and  potions  in  restoring  the  patient  to  health. 

Of  course  the  number  and  exact  arrangement  of  the  rooms  will  depend 
upon  the  purse  of  the  owner  ;  but  a  cottage  may  be  built  so  as  to  be  as 
healthy  as  a  palace, — and  indeed  the  advantage  is  often  in  favor  of  the 
former,  as  the  more  complicated  finishings  and  elaborate  furnishings  of 
the  latter  may  serv'e  as  harbors  for  dust  and  filth. 

Space  may  often  be  saved  by  doing  away  with  the  conventional  long, 
dark  hall,  and  by  having  the  stairs  go  up  from  a  sitting-room  or  from  a 
smaller  vestibule.  The  long  halls  are  often  cold,  dark,  and  dreary.  In 
winter  they  are  filled  with  cold  draughts,  and  in  summer  they  are  recep- 
tacles of  refuse  of  various  kinds,  and  at  all  times  they  are  cheerless. 
They  may  be  necessary  in  certain  houses,  but  in  small  homes  they  are 
neither  ornamental  nor  pleasant. 

It  is  the  ambition  of  most  American  housewives  to  have  a  parlor,  in 
which  the  most  valuable  household  ornaments  are  placed,  and  which 
opens  only  when  some  honored  guest  comes.  The  small  boys  of  the 
family  look  upon  it  as  forbidden  territory,  and  too  frequently  both  fresh 


BUILDING  A  HOME.  7 

air  and  sunlight  are  regarded  as  intruders,  and  are  shut  out.  The  exclu- 
sion of  the  small  boy  may  be  all  right,  but  the  air  and  sunlight  should  not 
be  treated  with  so  much  discourtesy.  Indeed,  they  should  be  considered 
the  most  honored  guests,  and  should  be  welcomed  even  to  a  place  in  the 
parlor. 

Probably  the  most  important  room  in  the  house  is  the  kitchen.  Before 
you  praise  the  housekeeping  of  any  woman,  visit  her  kitchen.  The  par- 
lor may  be  a  beauty,  the  bed  linen  may  be  spotless,  the  table  may  be 
covered  with  decorated  china,  but  if  the  kitchen  be  filthy,  all  is  in  vain. 
But  in  order  that  the  kitchen  maybe  kept  in  good  condition,  its  construc- 
tion must  be  proper.  The  floor  is  best  of  hard  wood  or  yellow  pine  ;  or, 
if  these  are  too  expensive,  of  selected  white  pine.  They  should  be  kept 
bare. 

At  least  two  windows,  one  on  each  side,  are  desirable.  A  pantry  or 
shelves  for  setting  aside  clean  cooking  utensils  and  dishes  should  be  at 
hand.  If  the  cellar  be  used  for  the  storage  of  vegetables,  an  inside  stair- 
way from  the  kitchen  or  pantry  should  lead  down  into  it.  The  flour-box 
in  the  pantry  should  be  so  hung  that  it  will  close  itself.  It  adds  much  to 
the  comfort  of  the  cook,  and  to  the  cleanliness  of  the  walls  and  ceiling  of 
the  room,  if  the  stove  or  range  be  covered  by  a  hood  which  conducts  the 
vapors  arising  from  the  cooking  food  into  a  flue  in  the  chimney. 

If  the  owner  can  possibly  afford  it,  the  house  should  contain  a  bath- 
room. In  the  absence  of  public  water-supply,  a  force-pump  below,  a 
cold-water  tank  in  the  attic,  and  a  hot-water  tank  attached  to  the  kitchen 
range  will  furnish  the  bath-tub.  The  room  should  be  heated  either  di- 
rectly or  from  another  room,  otherwise  it  would  not  be  used  much  in 
cold  weather.  The  cost  of  the  bath-room  and  its  supply  need  not  be 
great,  while  the  pleasure  and  benefit  derived  from  its  use  will  be  appre- 
ciated. 

THE    WINDOWS. 

The  importance  of  an  abundant  supply  of  sunlight  has  already  been 
insisted  upon.  If  possible,  every  room  should  have  direct  light,  and  not 
be  dependent  upon  that  which  is  diffused  through  an  adjoining  room. 
The  location  of  the  windows  should  be  such  as  to  give  the  greatest  amount 
of  direct  sunlight.  The  windows  should  extend  well  towards  the  ceiling, 
and  should  be  hung  so  as  to  lower  from  the  top  as  well  as  raise  from  the 
bottom. 

The  window  shutters  or  blinds  must  be  hung  in  such  a  manner  that 
they  are  easily  opened.  In  no  part  of  the  house  should  they  be  kept 
closed  during  the  day. 

HEATING    AND    VENTILATION. 

It  would  be  wholly  out  of  place  to  attempt  here  any  elaborate  discus- 
sion of  the  many  methods  of  heating  and  ventilating  buildings  now  in 
use.  Only  a  few  practical  statements  will  be  made  with  reference  to 
securing  adequate  warmth  and  sufficient  fresh  air  in  dwellings. 


8  BUILDING  A  HOME. 

The  most  common  methods  of  heating  small  residences  are  by  the 
stove,  open  fire,  and  hot-air  furnaces.  The  stove  is  the  most  econom- 
ical. The  open  fire  is  the  most  enjoyable,  and  v^here  it  is  sufficient,  the 
most  healthy  ;  but  in  the  Northern  states  the  open  fire  alone  seldom  fur- 
nishes enough  heat  during  the  coldest  inonths.  The  hot-air  furnace  may 
be  so  constructed  as  to  be  a  good  method,  but  care  must  be  used  in  select- 
ing the  furnace  and  arranging  for  ventilation. 

In  small  houses  the  heat  is  generally  supplied  by  stoves.  In  rooms 
which  are  occupied  only  during  a  few  hours  of  the  day  the  wood  stove 
is  sufficient,  and,  indeed,  has  certain  advantages.  The  room  can  be 
quickly  heated,  and  when  left,  the  fire  soon  dies  out,  thus  saving  fuel. 
But  where  the  room  is  constantly  occupied,  coal  is  a  more  suitable  fuel 
than  wood.  The  temperature  is  more  even,  and  the  fire  burns  more 
slowly.     The  relative  cost  of  these  fuels  varies  in  different  sections. 

The  coal  stove  should  have  no  loose  joints  through  which  gases  can 
escape.  The  mica  doors  should  be  kept  in  repair,  and  the  flue  must  not 
be  allowed  to  clog.  The  principal  gases  given  off*  from  burning  coal  are 
carbonic  acid  gas,  carbonic  oxide,  and  sulphurous  oxides.  The  carbonic 
oxide  is  poisonous  when  inhaled  in  any  quantity.  It  produces  a  sensa- 
tion in  the  head  similar  to  that  which  would  be  caused  by  a  tight  band  ; 
and  in  larger  amounts  it  renders  persons  insensible,  and  may  produce 
death.  It  should  be  remembered  that  the  carbonic  oxide  is  without  odor. 
Whole  families  have  been  fatally  poisoned  with  it.  Especial  care  must 
be  taken  with  coal  stoves  which  are  used  in  bed-rooms  or  in  rooms  which 
communicate  with  bed-rooms,  as  the  carbonic  oxide  may  prove  fatal  to 
persons  while  sleeping,  without  waking  them.  But  there  is  no  danger 
if  the  stove  and  flue  be  in  proper  condition.  Makers  of  wrought  iron 
stoves  and  furnaces  will  insist  that  these  gases  pass  readily  through  cast 
iron,  and  for  this  reason  their  stoves  are  superior,  and  free  from  danger ; 
but  a  properly  constructed  and  properly  managed  cast  iron  stove  or  fur- 
nace is  free  from  danger,  and  in  many  respects  is  superior  to  those  made 
of  wrought  iron.  Especial  attention  should  be  paid  to  the  position  of 
dampers  in  coal  stoves  at  night. 

One  of  the  greatest  objections  to  the  use  of  stoves  is,  that  in  houses  in 
which  they  are  used  there  is  generally  no  attempt  at  ventilation.  How- 
ever, a  house  heated  with  stoves  may  be  as  well  ventilated  as  any  other. 
In  houses  as  ordinarily  built,  much  fresh  air  will  come  in  through  the 
crevices  around  the  doors,  windows,  and  baseboards.  But  if  many  oc- 
cupy the  room,  the  amount  of  fresh  air  which  finds  admittance  through 
these  channels  maybe  insufficient :  especially  is  this  likely  to  be  the  case 
if  the  room  is  partly  surrounded  by  other  parts  of  the  building,  and  con- 
sequently has  but  a  small  surface  directly  exposed  to  the  out-door  air. 
Besides,  the  direct  draughts  from  doors  and  windows  may  be  so  great  as 
seriously  to  affect  the  health  of  the  inmates,  giving  them  colds.  When 
any  of  tlicse  troubles  exist,  one  of  several  simple  devices  may  be  resorted 
to  in  order  to  secure  the  admission  of  plenty  of  fresh  air  without  danger- 
ous draughts.     The  most  common  of  these  devices  consists  in  fitting  a 


BUILDING  A   HOME.  9 

piece  of  board  from  four  to  eight  inches  wide  in  the  window  frame  under 
the  lower  sash.  By  this  means  a  space  is  left  between  the  bottom  of  the 
upper  and  the  top  of  the  lower  sash,  through  which  the  air  enters,  and 
the  current  is  thrown  upward,  striking  the  ceiling,  from  which  it  is  dif- 
fused all  over  the  room.  Dr.  Keen  recommends  tacking  a  piece  of  cloth 
across  the  lower  eight  or  ten  inches  of  the  window  frame,  then  raising 
the  lower  sash  to  a  greater  or  less  extent,  according  to  the  weather.  In 
this  way  two  air  vents  in  the  window  are  established,  one  under  the 
lower  sash,  the  current  of  which  is  turned  upward  by  the  cloth,  and  the 
other  between  the  upper  and  lower  sash,  as  when  the  board  is  used. 
Through  the  upper  vent  it  is  supposed  that  some  of  the  foul  air  will  es- 
cape, though  the  current  through  this  opening  is  not  invariably  outward. 

What  is  known  as  Maine's  elbow-tube  ventilator  consists  of  a  board 
placed  under  a  raised  sash,  as  already  described.  This  board  carries  two 
tubes,  about  six  inches  in  diameter,  which  turn  upward,  and  the  ends  of 
which  are  supplied  with  valves  by  which  the  amount  of  in-flowing  air 
can  be  regulated. 

Another  method  provides  for  smaller  tubes  brought  through  the  wall 
and  turned  upwards  into  the  room.  Some  favor  still  another  plan,  which 
consists  in  bringing  a  tube  about  six  inches  in  diameter  through  the  wall, 
and,  possibly,  under  the  floor  to  the  stove,  where  the  tube  terminates  in 
a  sheet-iron  jacket  placed  around  the  stove,  leaving  a  space  of  one  or  two 
inches,  and  having  escapes  only  at  the  top  of  the  jacket.  The  heat  of 
the  stove  will  produce  a  strong  current  through  the  pipe,  and  the  incom- 
ing air  will  be  warmed  in  passing  through  the  jacket. 

By  any  of  the  above  mentioned  devices,  abundant  facility  may  be  fur- 
nished for  the  admission  of  fresh  air  ;  but  as  two  bodies  cannot  occupy 
the  same  space  at  the  same  time,  there  must  be  provided  some  escape  for 
the  foul  air.  This  should  always  be  attended  to  in  the  construction  of  the 
house.  For  every  room  which  is  to  be  heated  by  a  stove,  there  should  be 
two  flues,  one  for  the  smoke  and  other  gaseous  productions  of  combustion, 
the  other  for  the  removal  of  foul  air  from  the  room.  The  ventilating  flue 
must  come  to  the  floor,  just  above  which  should  be  a  register.  When 
there  is  a  flre  in  the  stove,  the  upper  part  of  the  ventilating  flue  will  be 
warmed  by  the  smoke  flue,  and  consequently  there  will  be  an  upward 
current  in  it.  In  this  way  the  withdrawal  of  the  foul  air  is  rendered  cer- 
tain. It  should  also  be  seen,  in  the  construction  of  the  chimney,  that  the 
inside  of  this  ventilating  flue  is  not  left  so  rough  as  to  impede  the  flow  of 
air  through  it,  and  that  it  is  not  clogged  with  mortar  or  pieces  of  brick. 
A  good  draught  through  the  ventilating  flue  is  almost  of  as  much  impor- 
tance as  the  draught  of  the  smoke  flue. 

The  partition  between  the  smoke  and  ventilating  flues  should  be  of 
brick  placed  on  edge,  thus  making  it  as  thin  as  possible,  so  that  the 
upper  part  of  the  ventilating  flue  will  be  thoroughly  heated  from  the 
smoke  flue.  By  another  method  the  smoke  flue  may  be  made  of  iron 
pipe  placed  in  a  large  flue,  and  the  space  all  around  the  pipe  will  serve 
as  the  ventilating  flue.     I  have  stated  that  the  register  in  the  ventilating 


10 


BUILDING  A  HOME. 


Fig.  I.— F.,  floor;  S.,  stove;  S.  P., 

stove  pipe;  V.  F.,  ventilating 

flue ;  C,  chimney. 


riue  should  be  near  the  floor.  If  near  the  ceiling,  as  some  would  have  it, 
there  would  be  too  great  a  loss  of  heat,  as  the  fresh  air  as  soon  as  heated 
would  find  its  exit.     For  summer  ventilation,  the  foul  air  outlet  may  be 

at  or  near  the  ceiling  ;  but  such  ventilation  in 
winter  costs  too  much,  and,  besides,  when  it  is 
used,  great  difficulty  will  often  be  experienced 
in  heating  the  room. 

With  the  plan  recommended  above,  there  is 
no  reason  why  any  room  heated  with  a  stove 
may  not  be  so  well  ventilated  that  no  disagree- 
able odor  will  be  perceptible  to  the  most  sen- 
sitive person  upon  coming  in  from  the  outdoor 
air  ;  provided,  always,  that  the  room  is  clean. 
Unfortunately,  however,  the  great  majority  of 
houses  which  are  heated  by  stoves  are  built 
without  the  slightest  provision  for  ventilation. 
In  such  houses,  fresh  air  maybe  introduced  according  to  the  methods  al- 
ready given  ;  but  the  escape  of  the  foul  air  is  more  difficult  to  be  provided 
for.  It  may  be  done,  however,  as  follows  :  Place  a  tin  or  sheet  iron 
pipe,  of  from  six  to  ten  inches  in  diameter,  according  to  the  size  of  the 
room,  along  the  wall  behind  the  stove.  The  lower  end  of  this  pipe  ex- 
tends to  within  a  few  inches  of  the  floor,  and  remains  open,  while  the 
upper  end  passes,  by  means  of  an  elbow,  into  the  smoke  flue  below  the 
point  at  which  the  stove  pipe  enters,  as  shown  in  the  accompanying 
Fig  I .  The  upper  end  of  the  ventilating  flue  may,  when  the  chimney 
begins  near  the  ceiling,  terminate  in  a  jacket  around  the  stove  pipe,  the 
jacket  passing  into  the  chimney  as  here  shown  in  Fig.  2.  In  all  cases 
the  ventilating  flue  is  to  have  air-tight  joints. 

With  the  open  fire  or  grate,  the  withdrawal  of  the  foul  air  is  all  pro- 
vided for,  as  it  will  escape  up  the  chimney.     The  open  fire  is  not  so 

economical  as  the  stove ;  but,  when 
sufficient  to  warm  the  room,  the  former 
is,  at  least  as  both  are  ordinarily  ar- 
ranged, more  healthful.  With  the 
open  fire  or  grate,  much  of  the  heat 
escapes  up  the  chimney ;  however, 
with  the  grate  this  loss  of  heat  can 
be,  to  a  considerable  extent,  lessened 
by  setting  the  fire-basket  well  forward. 
When  the  hot-air  furnace  is  used, 
certain  precautions  are  desirable,  both 
for  economy  and  health.  In  the  first 
place,  the  furnace  selected  is  nearly 
always  too  small  for  the  extent  of  heat- 
ing required  of  it.  When  this  is  the 
case,  the  fire  must  be  pushed  as  much  as  possible  in  order  to  keep  the 
rooms  warm  in  winter  ;  consequently  the  air  entering  the  room  is  over- 


Fig. 


BUILDING  A  HOME.  II 

heated,  and  produces  headache  and  dulness.  At  the  same  time  the  fur- 
nace is  soon  burnt  out,  and  any  money  saved  in  the  first  place  by  pur- 
chasing the  smaller  size  will  have  to  be  expended  with  an  additional 
amount  in  securing  a  new  furnace. 

The  furnace  should  be  thoroughly  encased  with  thick  brick  walls,  to 
prevent  great  loss  of  heat  by  direct  radiation  in  the  cellar.  The  owner  of 
the  house  will  be  rewarded  for  his  time  and  trouble  if  he  sees  to  it  that 
this  work  is'  well  done. 

The  furnace  must  receive  the  air  which  is  to  be  heated  directly  from 
the  out-door  air,  and  not  from  the  cellar.  The  cold-air  duct  should  be 
perfectly  air-tight,  so  as  wholly  to  prevent  the  cellar  air  from  entering 
the  heating  chamber.  Wooden  air-boxes  are  not  to  be  recommended 
unless  they  be  carefully  lined  with  some  metal.  The  external  opening 
of  the  cold  air  box  should  not  be  near  any  cesspool,  drain,  or  other  pos- 
sible source  of  deleterious  gases.  It  should  also  be  protected  by  a  piece 
of  wire  net.  In  the  cold-air  duct,  preferably  near  its  external  opening, 
should  be  a  sliding  valve,  by  which  the  amount  of  air  passing  to  the  fur- 
nace can  be  regulated  ;  but  care  must  be  taken  that  this  valve  is  never 
entirely  closed.  Probably  it  would  be  better  to  have  it  made  so  that 
when  pushed  in  as  far  as  possible  it  will  obstruct  only  half  the  area  of 
the  duct. 

The  air  chamber  in  the  furnace  should  be  kept  supplied  with  water. 
The  hot-air  flue  should  be  so  arranged  that  the  horizontal  ones  are  not 
more  than  fourteen  or  sixteen  feet  in  length,  for  if  the  horizontal  flues  be 
much  longer  than  this,  the  draught  through  them  will  be  so  slight  that 
the  rooms  will  not  be  warmed,  while  the  rooms  supplied  with  vertical 
pipes  will  be  over-heated. 

The  warm-air  register  in  the  room  should  not  be  placed  directly  in  the 
floor,  but  in  the  base-board.  If  placed  in  the  floor,  it  soon  receives  a 
large  amount  of  dust  and  other  refuse. 

With  a  hot-air  furnace  properly  selected  and  arranged,  the  amount  of 
warm,  fresh  air  entering  the  room  is  sufficient.  But  before  the  fresh, 
warm  air  can  enter,  the  air  already  present  must  find  an  exit.  The  fol- 
lowing principles  may  guide  us  in  economically  ventilating  a  room  heated 
with  a  hot-air  furnace  : 

(i)   Bring  the  fresh  air  in  near  the  floor. 

(2)  Take  the  foul  air  out  near  the  floor. 

(3)  Create  a  draught  in  the  foul-air  shaft  by  means  of  heat. 

Unless  the  air  already  in  the  room  has  some  means  of  exit,  it  will  be 
found  utterly  impossible  to  heat  the  room  with  the  warm-air  furnace. 
Then  it  will  be  seen  that  both  the  heating  and  ventilation  depend  largely 
upon  the  withdrawal  of  the  foul  air.  If  the  foul  air  register  be  near  the 
ceiling,  much  of  the  warm  air  from  the  furnace  will  escape  directly  into 
the  foul-air  shaft.  If  there  be  an  open  fire  in  the  room,  the  foul  air  will 
find  a  ready  exit  through  the  chimney.  If  there  be  only  a  ventilating 
flue,  it  should  be  in  the  same  chimney  w^ith  some  other  flue  which  is 
heated,  at  least  in  its  upper  half.     Thus  a  number  of  ventilating  flues 


12  BUILDING  A  HOME. 

from  as  many  rooms  may  be  placed  in  the  same  chimney  with,  and 
arranged  about,  the  smoke  flue  of  the  furnace.  Often  we  find  that  one 
ventilating  flue  is  expected  to  do  service  for  a  room  on  the  first  floor,  and 
also  for  another  directly  over  it  on  the  second.  The  result  frequently  is, 
that  the  foul  air  of  the  lower  room  passes  into  the  room  above.  There 
should  be  a  separate  ventilating  flue  for  each  room. 

WATER-SUPPLY. 

It  is  of  the  greatest  importance  to  the  family  that  its  supply  of  drinking- 
water  be  of  unquestionable  purity.  That  such  dreaded  diseases  as 
cholera,  typhoid  fever,  scarlet  fever,  diphtheria,  and  dysentery  may  be 
spread  by  impure  drinking-water,  there  can  now  be  no  question. 

The  sources  of  drinking-water  may  be  divided  into  the  following 
classes  : 

( 1 )  Ci  stern  water. 

(2)  Surface  water. 

(3)  Subterranean  water. 

Cistern  water  is  that  which  is  collected  upon  the  roof  of  a  house,  and 
stored  in  a  reservoir  known  as  a  cistern,  or  in  a  tank,  which  is  usually 
placed  in  the  attic  of  the  house.  Cisterns,  or  underground  reservoirs, 
are  more  generally  used  than  tanks. 

The  condition  of  this  kind  of  water  will  be  influenced  by  the  air  through 
which  it  falls,  by  the  nature  of  the  roof,  and  by  the  kind  of  cistern,  and 
the  care  exercised  in  keeping  the  roof  and  cistern  clean. 

In  large  cities,  especially  where  there  is  much  manufacturing  done, 
there  is  always  a  considerable  amount  of  dust  and  other  impurities  in  the 
air,  much  of  which  is  brought  down  with  the  rains.  The  conductors 
leading  from  the  roof  to  the  cistern  should  be  supplied  with  means  for 
turning  off'  the  first  part  of  the  rain-fall.  In  this  way  the  impurities  taken 
from  the  air  and  those  collected  on  the  roof  are  disposed  of.  Especially 
is  this  desirable  if  the  roof  be  of  wood  and  old,  if  there  be  a  collection  of 
leaves  and  other  debris  from  projecting  branches  of  trees,  and  if  there  be 
any  chance  of  birds  depositing  their  excrement  upon  the  roof.  Probably 
the  cleanest  roofing  material  is  slate  ;  but  its  cost  has  prevented  its  gen- 
eral use  in  the  construction  of  residences. 

The  cistern  should  be  built  of  brick,  and  plastered  water-tight  upon  the 
outside  as  well  as  upon  the  inside.  Strict  attention  should  be  paid  to 
this,  and  the  walls  should  be  so  built  as  to  prevent  the  possibility  of  water 
from  the  adjacent  soil  passing  into  the  cistern. 

The  top  of  the  cistern  should  be  well  covered,  so  as  to  prevent  small 
animals  as  well  as  vegetable  refuse  from  falling  in.  The  best  covering 
■would  be  a  box  built  up  several  feet  above  the  ground,  and  covered  with 
fine  wire  netting.  In  this  way  the  fresh  air  will  pass  down,  and  the 
space  above  the  surface  of  the  water  will  be  ventilated.  When  this  can- 
not be  used,  a  tight  covering  of  stone,  or  of  wood,  if  all  boards  are  re- 
moved and  replaced  by  new  ones  at  the  first  sign  of  decay,  may  be  used. 


BUILDING  A  HOME.  1 3 

A  wooden  pump  should  not  be  placed  in  the  cistern,  as  it  soon  decays, 
becomes  covered  with  moss,  and  collects  upon  it  much  filth.  An  iron 
pipe  with  the  pump  in  the  kitchen  is  probably  the  best  arrangement. 
However,  the  cistern  should  never  be  built  under  the  house.  When  so 
built  the  air  above  the  water  is  invariably  bad,  and  the  periodical  clean- 
ing out  of  the  cistern,  which  should  be  done  once  a  year  at  least,  is  not 
so  likely  to  be  attended  to. 

It  is  customary  in  some  places  to  place  near  the  top  of  the  cistern  an 
over-flow  pipe  which  leads  into  a  cesspool  or  privy-vault.  This  prac- 
tice has,  without  doubt,  cost  many  lives.  There  should  not  under  any 
circumstances  be  any  connection  between  the  cistern  and  any  receptacle 
of  filth.  This  over-flow  pipe  is  often  untrapped,  or  the  trap  becomes 
defective,  and  the  gases  arising  from  the  decomposing  matter  of  the  cess- 
pool and  privy-vault  pass  into  the  cistern.  Indeed,  cases  are  known 
where  not  only  the  gas,  but  fluid  refuse,  has  thus  been  poured  into  the 
cistern. 

However  much  care  may  be  taken  with  the  cistern, — and  the  above  sug- 
gestions should  be  deemed  of  imperative  importance, — the  cistern  water 
should  be  filtered  before  used.  Many  cheap  and  effective  household 
filters  are  made,  and  it  is  not  necessary  to  go  into  detail  concerning  their 
construction  ;  but  a  few  practical  hints  may  be  given  as  to  their  care.  A 
filter  which  is  kept  constantly  under  water  soon  becomes  utterly  worth- 
less. The  charcoal  box  should  be  frequently  exposed  to  air,  and,  if  pos- 
sible, to  direct  sunlight.  A  filter  removes  suspended  matter,  and,  on 
account  of  the  air  condensed  in  the  pores  of  the  charcoal,  destroys  to  a 
certain  extent  the  organic  matter  held  in  solution  in  the  water.  If  any 
epidemic  disease  prevail  at  the  time,  it  is  always  safest  to  boil  any  and 
all  water  used  for  drinking  purposes.  Cistern  water  may  be  boiled  and 
then  filtered.  If  one  has  no  regular  filter,  it  will  be  better  at  all  times  to 
boil  the  water,  after  which  it  may  be  allowed  to  run  through  a  piece  of 
filter  paper,  which  can  be  obtained  for  a  trifle  at  any  drug  store,  placed 
in  a  tin  or  glass  funnel.  When  filter  paper  is  used,  a  new  piece  should 
be  placed  in  the  funnel  each  day. 

The  purity  of  surface  "water  will  depend  on  the  condition  of  the  soil 
upon  which  it  falls  and  over  which  it  flows,  as  well  as  upon  the  air 
through  which  it  falls.  Water  which  falls  upon  and  flows  over  a  filthy 
soil  should  not  be  used  for  drinking.  Since  the  amount  of  refuse  on  the 
surface  of  the  earth  is  usually  greater  in  thickly  settled  countries,  the 
water  collected  on  such  sheds  is  unfit  for  use.  That  there  is  a  certain 
degree  of  purification  in  running  streams  there  can  be  no  doubt ;  but  not- 
withstanding this,  specific  poisons  have  been  carried  long  distances  in 
rivers,  and  have  still  manifested  their  poisonous  effects. 

When  any  serious  epidemic  prevails,  and  surface  w^ater  constitutes  the 
drinking  supply,  it  should  always  be  boiled.  In  India,  the  spread  of 
cholera  is  often  along  the  water-courses  into  which  excrement  from  the 
sick  and  the  bodies  of  the  dead  are  often  cast.  Typhoid  fever  and  dys- 
entery are  also  often  spread  by  the  use  of  surface  water. 


14  BUILDING  A  HOME. 

The  water  collected  in  shallow  wells  is  really  surface  water,  and  that 
often  of  the  worst  kind.  The  use  of  drinking-water  from  shallow  wells 
is,  as  a  rule,  to  be  condemned.  Many  people  think  if  water  percolates 
through  a  few  feet  of  soil,  every  harmful  substance  is  removed.  No 
greater  inistake  could  possibly  be  made.  Indeed,  by  percolation  through 
the  soil,  the  impurity  of  the  water  is  often  increased.  Various  kinds  of 
filth  which  have  accumulated  upon  and  within  the  soil  are  dissolved  in 
the  water  and  carried  into  the  well.  Often  we  find  in  a  small  back  yard 
a  cesspool,  privy-vault,  and  well,  all  in  close  proximity.  If  the  well  be 
a  shallow  one,  such  an  arrangement  is  probably  the  worst,  in  a  sanitary 
sense,  that  could  possibly  be  devised. 

Subterranean  waters  used  for  drinking  purposes  are  those  obtained 
from  springs  and  deep  wells.  Whether  such  waters  are  pure  or  not  de- 
pends largely  upon  the  genealogical  formations  in  which  they  exist.  The 
source  of  the  water  must  be  below  rock  or  thick  clay  beds  in  order  for 
the  water  to  escape  surface  contaminations.  Springs  from  gravel  hills 
may  be  as  impure  as  shallow  wells.  A  very  small  amount  of  iron  in 
water  does  not  render  it  unfit  for  drinking ;  but  water  which  contains 
more  than  one  tenth  of  one  per  cent,  of  iron  is  unfit  for  constant  use. 

Deep  wells  should  have  their  walls  so  protected  as  not  to  permit  of  sur- 
face water  finding  its  v\^ay  through  them.  If  this  is  not  the  case,  their 
waters  may  become  quite  as  foul  as  those  of  shallow  wells. 

Subterranean  waters  are  often  hard.  By  this  is  meant  that  they  fail 
to  make  a  lather  with  soap,  or  a  large  amount  of  soap  must  be  used  with 
them  in  order  to  produce  a  lather.  The  hardness  of  water  is  due  to  the 
presence  of  certain  inorganic  salts,  as  those  of  lime  and  magnesia,  which 
form  insoluble  compounds  with  soap.  Hard  waters  are  divided  into 
two  classes : 

(i)  Those  whose  hardness  is  removed  by  boiling.  This  is  known  as 
temporary  hardness. 

(2)  Those  whose  hardness  is  not  removed  by  boiling.  This  is  known 
as  permanent  hardness. 

Many  waters  possess  both  a  temporary  and  permanent  hardness. 
Such  waters  are  improved  by  boiling,  but  are  not  rendered  wholly 
soft. 

Hard  waters  are  not  suitable  for  laundry  purposes,  especially  when  the 
hardness  is  largely  permanent.  They  also  often  form  incrustations  in 
boilers.  But  unless  the  hardness  be  very  great,  it  does  not  unfit  the 
water  for  drinking  purposes.  There  has  been  much  discussion  as  to  the 
possibility  of  hard  waters  producing  goitre.  It  is  well  known  that  this 
disease  is  very  prevalent  in  certain  limestone  districts  ;  but  that  the  use  of 
hard  water  for  drinking  is  the  cause  of  the  disease  has  not  been  positively 
demonstrated.  It  would  be  best,  however,  for  families  in  which  a  ten- 
dency to  goitre  prevails  to  use  soft  water. 

Hard  water  has  also  been  supposed  to  favor  the  formation  of  gravel. 
The  writer  has  met  with  a  few  persons  who  are  troubled  with  gravel  only 
when  using  hard  water. 


BUILDING  A  HOME.  1 5 

Some  hard  waters  have  an  irritating  effect  upon  the  bowels  of  those 
not  accustomed  to  their  use,  producing  in  such  persons  diarrhoeas. 

In  case  of  the  use  of  a  public  water-supply,  it  is  the  duty  of  the  health 
authorities  of  the  city  to  see  that  the  water  is  wholesome,  and  it  is  the 
duty  of  the  consumer  to  see  that  the  water  is  not  contaminated  on  his 
premises.  Lead  pipes  and  lead  lined  storage  tanks  should  not  be  used 
for  conveying  or  storing  cistern  water.  The  pipes  should  be  of  iron,  or 
better  still,  of  block  tin,  or  should  be  lined  with  tin. 

THE    DISPOSAL   OF  WASTE. 

One  of  the  most  important  questions  connected  with  modern  sanitation 
is  as  to  the  best  methods  of  disposing  of  waste  matter.  When  allowed 
to  accumulate  in  the  vicinity  of  homes,  it  may  poison  both  the  water  and 
the  air.  Many  of  the  older  cities  of  southern  Europe  have  become  thor- 
oughly saturated  with  filth,  and  for  this  reason  cholera  has  found  a  fertile 
field  for  its  growth  in  Spain,  Italy,  and  southern  France.  Filth  and  dis- 
ease always  go  hand  in  hand,  the  former  leading  the  latter.  Cleanliness 
invariably  lessens  the  death-rate.  Typhoid  fever,  cholera,  and  other  dis- 
eases, whose  growth  and  spread  are  plainly  due  to  the  accumulation  and 
putrefaction  of  waste  matter,  should  be  stamped  out  of  existence.  With 
perfect  cleanliness  they  would  not  be  known. 

It  is  the  writer's  object  to  give  here  some  practical  suggestions  for  the 
disposal  of  waste  matter.  Probably  the  disposal  of  human  excrement 
deserves  more  care  than  any  other  waste.  In  cities  where  there  is  an 
abundant  public  supply  of  water,  and  where  sewers  are  in  use,  the  water- 
closet  is  the  most  convenient  method,  and  it  may  be  made  perfectly  safe. 
Where  water-closets  are  used,  the  so-called  "  separate  system"  of  sewer- 
age is  desirable.  This  system  provides  two  sets  of  sewer  conductors. 
One  of  these  is  the  ordinary  brick  sewer,  and  this  system  is  used  only 
for  carrying  off*  the  storm-water.  The  other  is  made  of  small  sewer 
pipes  which  convey  the  sewage  proper,  and  which  are  connected  with 
flushing  tanks,  by  means  of  which  they  are  periodically  flooded  with 
water  and  washed  clean.  The  advantage  of  this  method  is  easily  under- 
stood. When  the  single  system  is  used,  the  sewers  are  necessarily  large, 
ijti  order  to  carry  off'  the  great  amount  of  rain-water.  The  bottom  and 
sides  of  these  sewers  must  be  more  or  less  rough,  and  they  are  flushed 
only  at  the  time  of  heavy  rain-falls  ;  consequently  much  of  the  time  the 
flow  of  sewage  through  them  is  slow,  and  the  solid  matter  is  deposited 
on  the  rough  surfaces,  where  it  decomposes  with  the  formation  of  nox- 
ious gases,  which  escape  through  ventilators  into  the  street,  or  pass 
through  defective  traps  into  the  houses. 

With  the  separate  system  the  small  sewer  pipes  with  smooth  inner  sur- 
faces are  flushed  three  or  four  times  a  day,  and  their  contents  are  swept 
out.  It  requires  twenty-four  hours  at  least  for  human  excreta  to  decom- 
pose to  such  an  extent  as  to  evolve  poisonous  gases  ;  therefore,  if  the 
pipes  be  flushed  clean  one  or  more  times  during  the  day,  there  can  be 
but  little  danger  from  "sewer  gas." 


1 6  BUILDING  A  HOME. 

However,  whichever  system  of  sewerage  is  in  use,  the  individual 
should  take  certain  precautions  in  arranging  his  water-closets.  In  the 
first  place,  water-closets  should  not  be  placed  in  living-rooms  or  in  bed- 
rooms. They  should  be  located  if  possible  in  some  detached  part  of  the 
house.  The  kind  of  closet  selected  should  be  determined  upon  by  some 
competent  person.  Changes  and  improvements  in  the  patterns  are  being 
constantly  made,  so  that  should  any  preference  be  given  at  this  time  it 
might  not  hold  good  three  months  hence.  The  flushing  tank  for  the 
water-closet  should  not  in  any  way  be  connected  with  the  drinking  water- 
supply.  The  closet  should  be  well  trapped,  and  the  trap  should  be  so 
placed  that  it  can  be  examined  at  any  time  without  tearing  up  the  floor 
or  breaking  into  the  wall.  The  habit  which  plumbers  have  of  hiding  all 
their  work  should  be  condemned.  The  soil  pipe  should  not  be  connected 
at  any  point  inside  of  the  house,  at  least  with  the  other  waste  pipes,  such 
as  those  from  the  bath-tub  and  stationary  wash-bowls.  The  soil  pipe 
should  be  ventilated  by  a  pipe  which  should  be  as  nearly  perpendicular 
as  possible,  and  which  should  extend  above  the  roof  of  the  house,  and 
should  not  be  placed  near  a  window.  This  ventilation  of  the  soil  pipe  is 
of  the  utmost  importance,  and  should  never  be  neglected. 

When  there  is  no  system  of  sewerage,  the  dry-earth  closet  is  the  best 
method  of  disposing  of  human  excrement.  Indeed,  upon  sanitary  grounds 
the  dry-earth  system  is  in  many  respects  more  desirable  than  the  use  of 
water-closets  ;  but  the  former  requires  possibly  more  care  than  the  latter. 
Economically,  also,  the  dry-earth  system  will  prove  the  better  when  it 
comes  into  more  general  use,  and  the  excrement  is  used  as  a  fertilizer. 
A  dry-earth  closet  properly  kept  is  free  from  all  noxious  gases,  and  there 
is  no  possibility  of  the  drinking  water-supply  becoming  contaminated 
from  it. 

There  are  many  patterns  of  dry-earth  closets  in  use,  but  the  simplest 
may  be  made  as  efficient  as  the  most  complicated  and  costly.  A  cheap 
form  is  made  by  placing  under  the  seat  boxes  or  drawers  lined  with  gal- 
vanized iron.  There  is  placed  conveniently  a  quantity  of  dry  earth,  and 
for  each  evacuation  a  small  shovel  of  the  earth,  from  one  to  two  pounds, 
is  thrown  in.  When  the  drawers  are  full  they  are  removed,  emptied, 
and  replaced.  The  best  earth  to  use  is  pulverized  clay  mixed  with  about 
one  third  its  weight  of  loam.  Ordinary  garden  soil  maybe  used,  if  dried 
perfectly.  Sifted  coal  ashes  are  almost  or  quite  as  good  as  any  earth. 
Moreover,  they  are  generally  on  hand,  and  to  be  disposed  of  in  some 
way.  The  writer  has  used  for  his  family  a  dry-earth  closet  for  three 
years,  and  prefers  the  sifted  coal  ashes  to  any  kind  of  earth.  Gravel  is 
not  at  all  suitable. 

With  an  ordinary  family  with  not  more  than  half  a  dozen  members  it 
is  not  necessary  to  empty  the  boxes  more  than  once  in  three  or  four 
weeks.  Their  contents,  which  if  enough  soil  or  ashes  has  been  added, 
is  wholly  inodorous,  and  may  be  emptied  upon  the  garden.  Here  it  is 
spaded  in  during  the  spring,  and  as  a  fertilizer  amply  repays  for  the  time 
and  trouble  that  has  been  taken  with  it.     Several  large  cities  in  Europe 


BUILDING  A  HOME.  1/ 

have  adopted  the  dry-earth  system,  and  the  waste  is  removed  by  those 
who  desire  to  use  it  as  a  fertihzer. 

The  patent  earth-closets  are  so  arranged  that  the  requisite  amount  of 
earth  falls  into  the  box  in  a  manner  similar  to  that  by  w^hich  the  v^ater- 
closet  is  flushed  with  water. 

In  case  epidemics  of  any  kind  are  prevailing  in  the  neighborhood,  it 
would  be  well  to  throw  a  handful  of  chloride  of  lime  into  the  closet  each 
day.  And  even  when  no  epidemic  prevails,  but  the  weather  is  very  hot, 
the  same  quantity  of  sulphate  of  iron  (copperas)  may  be  used  daily. 
The  cost  of  this  substance  is  so  small  that  it  may  be  used  freely  when 
needed.  Where  many  are  using  the  closet,  a  vault  may  be  dug  beneath 
the  seat,  and  made  water-tight  with  brick  and  cement.  Into  this  should 
be  thrown  each  day  a  sufficient  quantity  of  this  dry  earth,  and  the  vault 
should  be  thoroughly  cleaned  at  least  once  a  month. 

The  ordinary  privy- vault  with  porous  walls  is  an  abomination.  It  has 
caused  more  deaths  in  this  country  than  war  and  famine  have  produced. 
The  liquid  poisons  from  it  filter  into  wells,  while  its  gaseous  exhalations 
float  through  the  air.  People  breathe  and  drink  their  own  excretions, 
and  typhoid  fever  and  kindred  diseases  slay  tens  of  thousands  annually. 
It  is  safe  to  say  that  the  privy-vault  is  the  origin  of  the  majority  of  the 
cases  of  typhoid  fever.  As  the  country  becomes  more  thickly  settled, 
the  dangers  from  the  privy-vault  increase,  and  they  should  be  wholly 
abandoned. 

In  many  places  it  is  the  custom  to  move  the  privy,  and  cover  the 
contents  of  the  vault  with  a  few  shovels  of  dirt  as  soon  as  the  vault  is 
filled.  In  this  way  from  one  to  half  a  dozen  repositories  of  filth  are 
formed  in  the  average  village  back  yard  in  a  few  years.  Such  a  condi- 
tion is  certainly  a  highly  unsanitary  one. 

The  waste-pipes  from  the  bath-tub  and  stationary  wash-bowls  should 
be  well  trapped,  with  the  traps  where  they  can  be  readily  examined  ; 
and,  as  has  been  stated,  these  waste-pipes  should  have  no  connection, 
inside  of  the  house  at  least,  with  the  pipe  from  the  water-closet.  In  the 
absence  of  sewage,  the  waste-pipes  from  the  bath  and  bowls  may  be 
conducted  into  a  cesspool.  If  the  soil  be  gravelly,  this  cesspool  should 
be  lower  than  the  bottom  of  the  cistern,  if  the  cistern  be  near.  Its  walls 
may  be  of  stone  or  brick  loosely  laid,  and  a  ventilating  pipe  should  pass 
from  the  top  of  the  cesspool,  and  extend  at  least  ten  feet  above  the  sur- 
face. No  kitchen  or  laundry  waste  should  be  allowed  to  pass  into  this 
cesspool.  Since  the  water  passing  into  this  cesspool  comes  only  from 
■  the  bath  and  wash-bowls,  it  does  not  contain  a  great  deal  of  organic  mat- 
ter, and  will  pass  into  the  soil.  The  cesspool  for  the  kitchen  slops  should 
be  walled  up  and  made  water-tight.  This  cesspool  should  also  be  ven- 
tilated by  means  of  a  large  vertical  pipe.  The  top  of  this  cesspool 
should  have  a  man-hole  in  its  centre,  covered  with  a  stone  or  iron  slab, 
w^hich  can  be  removed  in  order  to  clean  out  the  cesspool. 

It  is  better  for  all  pipes  leading  to  sewers  or  cesspools  to  be  discon- 
nected, or  furnished  with  gulley  traps  or  with  an  air  pipe  just  outside  of 


1 8  BUILDING  A  HOME. 

the  house,  in  order  to  prevent  the  possibility  of  gas  passing  from  the 
sewer  or  cesspool  into  the  house.  All  cesspools  should  be  as  far  from 
the  house  as  possible,  and  they  should  be  cleaned  at  regular  intervals. 
The  contents  of  the  kitchen  cesspool  may  be  used  for  fertilizing. 

All  solid  kitchen  waste  should  be  removed  daily  by  a  scavenger,  who 
does  this  without  expense  to  the  householder,  or  it  may  be  dried  under  the 
kitchen  stove  in  shallow  pans  and  then  burned  in  the  kitchen  fire,  or,  if 
in  the  country,  it  may  be  fed  to  hogs  or  other  animals. 

The  dust  swept  from  the  floor  should  be  burned,  not  thrown  out  into 
the  yard.  Ashes  should  be  kept  in  a  dry  place,  and  if  so  kept  they  may 
often  be  disposed  of  without  cost.  The  soap-maker  will  pay  for  dry 
wood  ashes,  and  coal  ashes  are  often  sought  for  and  used  for  filling  in 
low  places.  Each  fire-place  and  grate  should  be  furnished  with  an  ash- 
pit in  which  the  winter's  product  may  fall,  and  by  which  accident  from 
fire  is  greatly  lessened. 

When  a  house  is  built,  a  plan  of  all  its  drainage  pipes  should  be  made 
and  preserved,  as  with  it  a  faulty  pipe  or  joint  may  often  be  found  with 
ease,  when  without  it  much  work  may  be  necessary  in  order  to  find  where 
the  trouble  is. 

THE    SURROUNDINGS. 

It  would  be  better  if  residences  were  not  built  up  in  solid  blocks. 
Even  narrow  passage-ways  between  the  houses,  through  which  the  air 
can  move  freely,  are  to  be  preferred  to  unbroken  blocks.  However,  the 
price  of  land  and  of  building  material  may  compel  some  in  the  larger 
cities  to  deny  themselves  any  further  separation  from  their  neighbor  than 
that  afforded  by  a  single  brick  wall.  But  under  no  censideration  should 
residences  be  built  back  to  back,  without  any  open  space  between  the 
kitchens  of  the  two  houses.  Even  a  few  feet  of  open  yard  are  of  great 
benefit  in  affording  ventilation,  and  in  preventing  excessive  dampness. 
The  yard  should  be  kept  scrupulously  clean,  and  it  should  be  rendered 
as  beautiful  as  circumstances  will  permit.  In  summer  there  is  no  place 
for  children  in  their  play  preferable  to  a  nice  spot  out  of  doors. 

The  arrangement  of  cesspools,  wells,  cisterns,  and  out-houses  has 
already  been  discussed.  None  of  these  should  be  allowed  to  contam- 
inate the  soil  or  air  of  the  yard.  Trees  not  too  dense  or  too  near  the 
house  are  beneficial  in  shutting  off  dust,  and  tempering  the  heat  of  the 
summer's  sun.  Besides,  no  other  ornament  about  the  premises  can  be 
more  attractive  than  beautiful  trees. 

The  location  of  all  the  out-houses  of  the  immediate  neighbors,  as  well 
as  those  directly  on  the  premises,  should  be  taken  into  consideration. 
The  yard  should  be  so  graded  that  the  surface  water  will  not  collect  about 
■the  foundations  of  the  house. 

A  little  care  and  a  trifling  expense  in  the  surroundings  will  amply 
repay  any  family,  and  will  increase  one's  love  for  what  should  be  the 
dearest  spot  on  earth — home. 


BUILDING  A  HOME.  1 9 

THE    CARE    OF   THE    HOME. 

Suppose  that  a  location  has  been  selected,  a  house  built,  and  the  sur- 
roundings prepared  according  to  the  foregoing  directions,  the  next  thing 
is  to  see  that  all  is  kept  in  a  sanitary  condition.  Some  families  would 
convert  the  most  scientifically  constructed  house  into  a  den  of  filth. 
Cleanliness  should  be  the  watchword  of  every  family.  So  far  as  san- 
itary needs  are  concerned,  all  the  directions  under  this  head  might  be 
condensed  into  the  few  words,  "Keep  everything  clean." 

Decaying  vegetables  must  not  be  left  in  the  cellar.  Fresh  air  is  to  be 
admitted  daily  into  every  part  of  the  house,  from  cellar  to  garret.  Bed- 
rooms especially  are  to  be  thoroughly  aired.  Refuse  bits  of  food  are  not 
to  be  left  to  mold  on  the  pantry  shelf,  nor  should  they  be  thrown  out  into 
the  back  yard.  Better  burn  thein.  Offal  from  the  preparation  of  food  is 
not  to  be  allowed  to  remain  in  the  house,  nor  is  it  to  be  thrown  out.  It 
must  be  placed  in  the  swill  barrel,  or  burned.  Dirty  dishes  are  not  to  go 
unwashed,  nor  filthy  floors  unscrubbed,  nor  soiled  linen  unlaundered. 

Fresh  meat,  milk,  and  other  foods  are  not  to  be  allowed  to  remain 
uncovered  in  living-rooms  or  bed-rooms.  The  flour-box  is  to  be  kept 
free,  not  only  from  the  ravages  of  rats  and  mice,  but  from  the  dust  of  the 
room. 

The  drain  from  the  ice-box  should  not  be  allowed  to  pass  into  a  cess- 
pool, sewer,  or  soil-pipe.  Indeed,  there  should  be  no  kind  of  connection 
between  the  ice-box,  or  other  place  in  which  food  is  kept,  and  any  recep- 
tacle of  waste  matter. 

The  floors  and  seats  of  water-closets  and  earth-closets  are  to  be  kept 
clean.  Drains  and  cesspools  must  be  attended  to.  The  supply  of  drink- 
ing-water must  be  kept  free  from  every  contamination. 

Continued  health  is  the  reward  for  the  care  bestowed  upon  these 
details.     The  labor  brings  a  rich  return. 

BUYING   OR   RENTING  A   HOUSE. 

Great  care  should  be  exercised  in  renting  or  buying  a  house  for  family 
occupation.  Many  houses  are  now  built  purposely  to  rent  or  sell,  and 
too  many  of  these  are  constructed  in  a  very  flimsy  manner.  The  object 
of  the  builder  is  to  attract  attention  to  his  house,  and  money  is  spent  in 
ornamentation,  which  should  have  been  used  in  the  more  important  parts 
of  the  structure.  No  one  should  place  his  family  in  a  house  until  he  has 
made  a  thorough  investigation  of  its  sanitary  condition.  The  mere  adver- 
tisement that  "the  house  is  furnished  with  the  most  approved  sanitary 
appliances"  should  not  be  considered  as  a  sufficient  guaranty.  Indeed, 
the  statement  of  the  owner  or  agent,  that  "everything  is  all  right."  is 
usually  not  to  be  relied  on.  The  time  will  come  when  no  one  will  be 
permitted  to  rent  a  death-trap  in  the  shape  of  a  house  ;  but,  unfortunately 
at  present,  the  duty  of  seeing  that  everything  is  really  all  right  devolves 


20  BUILDING  A  HOME. 

upon  the  person  seeking  a  house.  For  this  reason  a  few  practical  direc- 
tions for  house  inspection  may  not  be  out  of  place  here.  The  writer  has 
known  a  man,  even  after  having  been  warned  by  a  former  tenant,  who 
placed  his  family  in  a  house  whose  sole  recommendation  was  its  attrac- 
tive appearance,  and  to  regret  his  rashness  a  few  weeks  later  when 
t}^phoid  fever  had  stricken  his  family.  The  dangers  to  health  and  life 
are  too  great  to  allow  any  one  to  be  careless  or  indifferent  in  this  matter. 

The  house  offered  for  rent  or  sale  should  be  visited  by  the  one  seeking 
a  home,  and  thoroughly  inspected  in  regard  to  its  sanitary  condition,  as 
well  as  to  its  general  appearance.  The  surroundings  should  be  studied. 
The  condition  of  the  back  yard, — especially  the  location  of  out-houses 
on  the  premises  and  those  of  the  neighbors, — the  location  and  condition 
of  cesspools,  privy-vaults,  cisterns,  or  wells,  if  such  be  present,  should 
undergo  careful  inspection.  What  the  sanitary  arrangements  should  be 
has  been  already  sufficiently  indicated. 

The  cellar  should  be  visited,  and  if  its  walls  be  cracked,  damp,  and 
covered  with  mold,  if  water  stands  upon  its  floor,  and  if  light  and  ven- 
tilation are  not  provided  for,  seek  some  other  habitation.  It  is  better  far 
to  sleep  in  the  open  air,  with  no  roof  but  the  sky  and  no  bed  but  a  few 
blankets  placed  on  the  dry  earth,  than  to  live  in  a  house  built  over  a 
reeking  cesspool ;  and  such  a  cellar  is  nothing  more  nor  less  than  a 
cesspool. 

The  general  construction  of  the  house  should  be  closely  scrutinized. 
Observe  the  height  of  the  first  floor  above  the  level  of  the  street,  the  pro- 
portion of  the  lot  covered  by  the  house,  the  arrangement  and  size  of  the 
rooms,  and  the  condition  of  the  floors,  ceilings,  and  walls.  Of  course 
newly  constructed  walls  are  always  damp.  A  great  amount  of  water  is 
used  in  the  mortar  and  plastering,  and  much  of  this  must  evaporate 
before  the  building  is  fit  for  occupation.  Neither  should  a  house  freshly 
painted  with  lead  paints  be  occupied  until  the  paint  is  well  dried.  The 
living-rooms  should  be  placed  upon  the  sunny,  airy  side  of  the  house. 
The  bed-rooms  especially  should  be  examined  with  reference  to  their 
size  and  means  of  ventilation.  The  floors  should  be  of  seasoned  wood, 
well  jointed.  This  is  very  desirable,  as  it  prevents  the  accumulation  of 
dirt  under  the  floors,  and  permits  of  the  free  use  of  water  in  scrubbing 
the  upper  floors  without  danger  of  injury  to  the  ceilings  of  the  lower 
rooms. 

"  Skin"  houses,  put  up  by  "jerry"  builders  simply  to  rent  or  sell  at  the 
highest  price,  can  usually  be  recognized  by  careful  inspection.  Extra 
ornamentation  will  generally  be  observed,  but,  if  a  few  months  have 
elapsed  since  its  construction,  doors  will  be  noticed  not  to  close  tightly, 
the  wood-work  is  shrunken,  the  window-sashes  do  not  move  easily,  and 
too  frequently  the  foundations  have  settled  and  the  walls  cracked. 

If  the  house  be  furnished  with  any  plumbing,  this  should  undergo 
thorough  inspection.  A  map  showing  the  distribution  of  the  pipes, 
unless  all  are  in  plain  view,  should  be  furnished  by  the  owner.  In  many 
old  houses  large  brick  drains  are  found  in  the  cellar.     These  are  always 


BUILDING  A  HOME.  21 

bad.  In  them  a  great  quantity  of  filth  accumulates.  They  are  seldom 
sufficiently  flushed.  Such  a  condition  should  lead  one  to  reject  a  house 
for  residence.  If  the  drain  in  the  cellar  be  of  earthen  pipe,  its  joints 
should  be  examined,  for  they  are  often  imperfect,  and  allow  of  the  escape 
of  both  gaseous  and  liquid  contents.  In  this  way  the  cellar  floor  becomes 
impregnated  with  filth,  and  from  It  noxious  exhalations  rise  into  the 
rooms  above.  The  writer  has  known  of  more  than  one  instance  in 
which  one  of  these  drains  has  been  broken  by  settling,  and  the  conse- 
quence was  that  a  regular  cesspool  -was  formed  instead  of  the  drain.  In 
one  instance  the  break  occurred  near  a  cistern,  and  much  of  the  chamber 
and  kitchen  slops  soaked  through  the  imperfect  cistern,  polluting  the 
water ;  and  this  was  the  probable  cause  of  the  typhoid  fever  which 
attacked  four  of  the  inmates  of  the  house.  Still  worse  is  the  box  drain 
made  of  plank.  Often  at  the  junction  of  the  vertical  pipe  with  such  a 
drain,  the  wood  decays,  and  a  filthy  cesspool  is  formed. 

Unfortunately  in  most  cities  the  sewers  pass  along  the  street  in  front 
of  the  house,  and  the  sewage  is  collected  in  the  back  part  of  the  cellar, 
and  carried  by  a  drain  under  the  floor  for  the  entire  length  of  the  cellar, 
passing  out  under  the  front  wall  on  its  way  to  the  sewer.  The  best  place 
for  the  sewer  is  in  the  rear  of  the  house,  but  when  in  front,  the  drain 
should  be  carried  around  the  house  ;  or,  if  through  the  cellar,  it  should 
consist  of  an  iron  pipe  freely  exposed  along  its  entire  length,  and  with 
sufficient  fall  to  give  a  rapid  cuiTent.  Its  grade  should  be  unifoi'm,  and 
free  from  depressions  in  which  accumulations  might  occur. 

The  proper  arrangement  of  the  soil  pipe  has  already  been  referred  to. 
It  should  be  of  iron,  not  of  lead.  Leaden  soil-pipes  are  often  corroded 
and  leaky.  The  ventilation  of  the  soil-pipe  should  be  by  means  of  a 
pipe  extending  above  the  roof.  The  water  conductor  from  the  roof 
should  not  be  made  to  do  service  as  a  ventilating  pipe.  Moreover, 
when  the  rain-water  conductor  empties  into  the  soil-pipe  the  force  of  the 
current  through  it  will  siphon  the  traps  above  unless  they  are  all  ven- 
tilated. 

The  location  of  all  traps  should  be  ascertained,  and  it  should  be  seen 
that  none  of  the  pipes  ai^e  either  clogged  or  leaky.  The  desirability  of 
the  separation  of  the  water-closet  from  the  bath  and  wash-bowls  has 
already  been  referred  to.  It  is  not  desirable  to  have  even  stationary 
wash-bowls  in  bed-rooms. 

If  there  be  a  v\^ater-supply.  It  is  well  to  see,  before  renting  or  buying 
the  house,  that  all  the  pipes  are  in  good  order  and  so  protected  that  they 
v^ill  not  freeze.  If  the  drinking-water  be  stored  in  a  tank,  see  that  the 
tank  is  not  lined  with  lead.  All  water  pipes  should  be  well  supported, 
or  they  may  sag  and  break. 

The  Inspection  of  the  method  of  heating  and  ventilating  the  building 
may  be  made  from  the  rules  in  regard  to  these  points  already  given. 
The  same  Is  true  in  regard  to  the  disposal  of  garbage  and  the  construc- 
tion of  earth-closets. 


22  BUILDING  A  HOME. 

TENEMENT-HOUSES. 

Every  working-man  should  strive  to  secure  a  home,  and  the  tenement- 
house  can  never  be  a  home  in  any  proper  sense.  The  privacy  and  com- 
fort of  a  home  can  never  be  secured  in  a  tenement-house.  Here  people 
of  all  kinds  are  congregated,  and  the  noise  of  the  boisterous  will  disturb 
the  rest  of  the  quiet ;  the  filth  of  the  slovenly  is  likely  to  injure  the  health 
of  those  who  endeavor  to  keep  everything  about  them  clean ;  and  the 
habits  of  the  immoral  are  distasteful  to  the  moral.  However,  on  account 
of  poverty,  many  good  people  are  compelled,  for  a  time  at  least,  to 
occupy  rooms  in  a  tenement-house.  Unfortunately,  the  majority  of  such 
houses  are  built  for  the  purpose  of  making  as  large  pecuniary  return  to 
the  owner  as  possible,  and  he  cares  but  little  about  the  character  of  his 
tenants  or  the  manner  in  which  they  live,  so  long  as  their  rent  is  paid. 
In  the  large  tenement-houses  of  New  York,  all  kinds  of  occupations  are 
carried  on,  and  many  of  them  in  the  most  slovenly  manner. 

The  tenement  should  have  a  cellar  under  every  part  of  it.  The  cellar 
should  be  divided  into  compartments  by  brick  walls.  No  part  of  it 
should  be  used  for  sleeping-rooms,  and  it  should  be  perfectly  dry  and 
well  ventilated.  The  walls  and  floors  throughout  the  building  should  be 
deadened.  The  halls  should  be  lighted  at  both  ends.  They  should  be 
wide,  and  the  space  should  not  be  encroached  upon  by  using  them  as 
storage  rooms. 

Each  water-closet  should  be  thoroughly  trapped  and  ventilated  by  a 
pipe  extending  above  the  roof.  The  ends  of  these  pipes  should  not  have 
return  bends,  nor  be  furnished  with  caps  which  are  likely  to  obstruct  the 
upward  current. 

The  water-pipes  from  baths,  stationary  wash-bowls,  laundry  tubs,  and 
sinks  should  have  no  connection  with  the  water-closets,  and  should  dis- 
charge into  the  open  air  outside  the  building  over  gullies,  or  should  pass 
through  air-traps  outside  of  the  house,  the  air-trap  having  a  large  ven- 
tilating pipe  carried  above  the  roof.  In  this  way  there  will  be  no  con- 
nection between  the  drain  or  sewer  and  the  inside  of  the  house,  except 
through  the  ventilated  soil-pipe  of  a  trapped  water-closet. 

The  floor  and  seat  of  every  water-closet  should  be  scalded  with  hot 
water  and  soap  at  least  twice  a  week.  There  should  be  a  separate  closet 
for  every  fifteen  persons. 

The  laundry  work  should  be  done  in  some  special  place,  and  not  in  the 
Jiving-  or  sleeping-rooms.  The  water-supply  should  be  abundant ;  and 
where  the  water-closets  are  used,  not  less  than  thirty  gallons  per  day  for 
each  inmate  of  the  house.  Kitchens  and  bed-rooms  should  be  separate. 
The  minimum  amount  of  cubic  space  allowed  should  be  five  hundred 
cubic  feet  per  head,  and  this  amount  will  answer  only  when  ample  pro- 
vision for  ventilation  exists. 

Each  room  should  be  lighted  by  outside  windows  or  by  light-shafts. 
The  window  sash  should  lower  from  the  top  as  well  as  raise  from  the 
bottom.     Each  room  must  be  furnished  with  a  separate  flue  for  ventila- 


BUILDING  A  HOME.  23 

tlon,  or  a  foul-air  shaft,  which  should  be  heated.  These  shafts  may  be 
heated  by  being  placed  in  the  same  chimney  with  smoke  flues,  or  in  case 
the  entire  building  is  heated  by  steam,  a  number  of  foul-air  shafts  may  be 
brought  together  in  the  attic,  and  heated  by  a  steam  coil.  If  this  is  done 
there  should  be  no  means  of  cutting  off  the  steam  from  this  coil.  The 
method  of  removing  foul  air,  by  means  of  a  large  central  shaft,  may  do 
when  there  are  conductors  leading  from  each  room  to  such  a  shaft,  but 
when  it  depends  upon  the  foul  air  from  distant  rooms  reaching  the  shaft 
by  means  of  open  doors  or  through  transoms,  it  will  often  fail.  More- 
over, all  attempts  to  ventilate  a  number  of  rooms  on  different  floors 
through  the  same  flue  or  shaft,  it  matters  not  how  large  it  may  be,  will 
always  prove  more  or  less  of  a  failure  ;  because,  on  account  of  difference 
in  temperature,  the  foul  air  from  one  room  will  often  pass  into  another. 


HEALTHY  FOODS. 

FOODS   AND    FOOD-STUFFS. 

Since  particles  of  our  bodies  are  constantly  being  worn  away  and  cast 
out,  new  material  must  be  introduced  in  order  to  make  good  the  loss. 
Again  :  it  is  necessary  that  our  bodies  should  be  supplied  with  force  or 
energ}-,  that  animal  heat,  muscular  movement,  and  nervous  activity  may 
be  maintained.     For  these  reasons  foods  are  taken. 

Foods  may  be  defined  as  substances  which  when  taken  into  the  body 
aid  in  building  up  or  repairing  tissue,  or,  by  being  oxidized  or  burned, 
generate  force  or  energy. 

Our  ordinary  foods  consist  of  certam  food-stuffs  or  elementary  princi- 
ples, together  with  a  greater  or  less  amount  of  wholly  indigestible  sub- 
stances. Thus,  oatmeal  is  a  food  containing  the  food-stuffs,  gluten, 
starch,  and  fat,  with  a  certain  amount  of  cellulose  (cell  structure)  which 
is  of  no  service  to  the  body.  The  nutritive  value  of  a  food  depends  upon 
the  kind  and  amount  of  these  food-stuffs  that  it  contains.  Since  no  satis- 
factory discussion  of  foods  can  be  carried  on  until  we  become  acquainted 
with  those  constituents  upon  which  their  values  depend,  we  will  briefly 
consider  the  food-stuffs.  Fortunately  they  are  not  numerous,  and  may- 
be divided  into  the  following  classes  : 

(i)   Albumens  or  proteids. 

(2)  Fats  or  oils 

(3)  Starches  or  carbohydrates. 

(4)  Inorganic  salts. 

(5)  Water. 

Albu7ncns  or  Proteids.  To  this  group  belong  some  of  the  most  impor- 
tant food-stuffs.  They  all  contain  nitrogen,  and  for  this  reason  the  term 
"  nitrogenous  constituents"  is  used  sometimes  instead  of  proteids  or  albu- 
mens. The  chief  proteids  are  ordinary  albumen,  as  the  white  of  ^Z^., 
casein  of  milk,  fibrine  of  meat,  gluten  of  grains  and  flour,  and  legumine 
of  pease  and  beans.  The  amount  of  proteid  in  the  different  foods  is  varia- 
ble ; — thus,  meat  contains  from  15  to  23  per  cent.  ;  milk  from  3  to  4 ; 
pease  and  beans  from  23  to  27  ;  grains  and  flours  from  8  to  1 1  ;  bread 
from  6  to  9  ;  and  potatoes  and  greens  from  i  to  4. 

When  we  remember  that  the  blood,  muscles,  and  all  the  vital  organs 
contain  proteids  as  their  chief  constituents,  we  can  understand  the  impor- 
tance of  taking  food  rich  in  one  or  more  members  of  this  group.  The 
average  working-man  requires  in  his  daily  food  the  equivalent  of  four  or 
five  ounces  of  pure  proteid. 


HEALTHY  FOODS.  2$ 

The  digestive  and  assimulative  organs  have  the  power  of  converting 
one  proteid  into  another,  but  thc}^  are  not  able  to  form  a  proteid  out  of  a 
fat  or  a  starch.  For  this  reason  no  other  food-stuffs  can,  without  injury, 
be  a  substitute  for  the  proteids  in  our  food  for  any  length  of  time. 

Fats.  Fats  when  oxidized  or  burned  in  the  body  produce  more  force 
than  will  arise  from  the  combustion  of  an  equal  weight  of  any  other  food- 
stuff. In  cold  countries  the  inhabitants  instinctively  consume  large 
amounts  of  fat  on  account  of  the  heat  which  is  generated  from  it.  The 
working-man  requires  not  less  than  two  ounces  of  fat  per  day.  Fats  are 
best  digested  when  taken  in  a  finely  divided  state. 

Starches  or  Carbohydrates.  To  this  group  belong  a  number  of  sub- 
stances of  similar  chemical  composition,  and  the  majority  belong  to  veg- 
etable foods.     The  most  important  are  starch,  sugar,  gum,  and  dextrine. 

Like  the  fats,  they  are  consumed  in  giving  energy  to  the  body,  though 
a  much  larger  amount  of  the  carbohydrates  is  required  to  yield  the  same 
result  to  the  body.  The  daily  need  of  this  food-stuff  by  the  average 
working  man  is  between  seventeen  and  eighteen  ounces. 

The  cellulose  or  cell  structure  of  plants  is  closely  allied  to  the  members 
of  this  group,  and  any  cellulose  that  is  absorbed  must  first  be  converted 
into  sugar. 

Mineral  Salts.  The  bones  of  the  adult  man  contain  as  much  as  70 
percent,  of  mineral  matter,  the  greater  part  of  which  is  the  phosphate 
of  lime.  Smaller  quantities  of  the  phosphate  of  magnesium  and  the  car- 
bonate of  lime  also  exist  in  bones.  The  muscles,  blood,  and  tissues  also 
contain  salts  of  potash  and  soda,  and  some  ii^on.  One  of  the  most  im- 
portant mineral  foods  is  common  salt  or  the  chloride  of  sodium. 

Water.  About  70  per  cent,  of  the  adult  body  is  water.  It  forms  the 
greater  part  of  the  vital  fluid,  in  which  it  serves  as  the  carrier  of  other 
substances,  some  in  solution,  others  held  in  suspension.  Besides  the 
fluids,  the  solid  tissues  contain  a  greater  or  less  proportion  of  water :  the 
muscles  contain  as  much  as  75  per  cent.  There  is  also  great  loss  of 
water  by  evaporation  from  the  skin,  by  exhalation  from  the  lungs,  and 
by  excretion  from  the  kidneys  and  bowels.  This  loss  must  be  made 
good  by  the  drinking  of  water,  and  by  taking  foods  more  or  less  rich  in 
this  constituent.  Meat  contains  about  75  per  cent.  ;  milk  on  an  average, 
87  ;  bread,  35  ;  and  vegetables  and  fruits,  from  70  to  90. 

THE    NUTRITIVE    VALUE    OF    FOODS. 

The  nutritive  value  of  a  food  will  depend  upon  the  proportion  and 
kind  of  food-stuffs  which  it  contains.  However,  there  are  many  condi- 
tions which  influence  the  nutritive  value  of  a  food.  In  order  for  this  to 
be  high,  its  constituents  must  not  only  be  rich  in  food-stuffs,  but  they 
must  be  digestible.  By  improving  the  digestion,  the  appearance,  odor, 
and  taste  of  a  food  increase  its  nutritive  value.  A  certain  method  of  cook- 
ing makes  a  food  more  acceptable  to  one,  while  another  is  pleased  with 
a  wholly  different  manner  of  preparation.     The  taste  and  odor,  when 


26  HEALTHY  FOODS. 

pleasing,  stimulate  the  flow  of  the  digestive  juices  ;  and  not  only  will 
more  of  the  food  be  taken  as  a  result,  but  a  greater  proportion  of  that 
which  is  taken  will  be  digested  and  assimilated. 

It  is  also  quite  essential  that  the  volume  of  food  taken  should  be  large 
enough  to  satisfy  the  appetite,  and  still  not  so  great  as  to  prove  burden- 
some. For  this  reason  foods  poor  in  certain  food-stuffs  are  usually  taken 
with  some  other  food  rich  in  these  constituents.  Thus,  the  potato,  which 
contains  not  more  than  2  per  cent,  of  proteids,  is  usually  eaten  with 
meat,  which  contains  from  14  to  21  per  cent,  of  proteids ;  or  we  may 
say  with  equal  propriety,  that  because  meat  contains  no  starch,  man  has 
learned  to  take  with  it  the  potato,  whose  chief  constituent  is  starch.  If 
one  should  attempt  to  live  upon  potatoes  only,  the  weight  of  the  food  that 
he  would  have  to  take  each  day  in  order  to  get  the  minimum  quantity  of 
proteids  upon  which  life  could  be  sustained  would  not  be  less  than  ten 
pounds.  Dr.  Edward  Smith  actually  found  some  of  the  poorest  Irish 
laborers  confined  almost  exclusively  to  potatoes,  and  consuming  the 
amount  given  above.  This  would  lead  to  distention  of  the  digestive 
organs,  and  render  one  dull  and  stupid.  The  digestive  organs  of  plant- 
eating  animals  form  from  15  to  20  per  cent,  of  the  entire  body  weight. 
In  flesh-eating  animals  the  digestive  organs  form  only  from  5  to  6  per 
cent,  of  the  body  weight ;  in  man  the  proportion  is  from  7  to  8  per  cent. 
Thus,  man,  upon  this  point  at  least,  holds  an  intermediate  position  be- 
tween flesh-eating  and  plant-eating  animals,  being  more  closely  allied  to 
the  former  than  to  the  latter.  However,  as  the  proper  cooking  of  the 
food  aids  digestion,  man  may  digest  some  of  the  vegetable  food  even 
more  quickly  and  completely  than  the  ox  can.  But  his  food  should  not 
consist  wholly  of  vegetable  products.  A  certain  amount  of  animal  food, 
while  not  absolutely  necessary  to  the  maintenance  of  life,  is  essential  to 
man's  highest  development. 

The  nutritive  values  of  the  different  foods,  as  shown  by  the  per  cent, 
of  the  various  food-stuffs  which  they  contain,  will  be  given  under  the 
special  description  of  each  food. 

THE  ECONOMIC  VALUE  OF  FOODS. 

That  food  is  most  economical  which  contains  the  greatest  amount  of 
the  most  valuable  food-stuffs  for  the  least  money. 

The  average  working-man  requires  daily  in  his  food,  in  round  num- 
bers, not  less  than  four  ounces  of  proteids,  two  ounces  of  fat,  and  eighteen 
ounces  of  carbohydrates.  What  combination  of  foods  will  furnish  these 
for  the  least  money.?  This  is  an  important  question  ;  but  in  answering 
it,  it  should  always  be  borne  in  mind  that  the  foods  suggested  are  to  be 
healthy  ones.  A  combination  which  would  cost  but  little,  but  which 
would  lead  to  dyspepsia  or  other  ills,  might  in  the  end  be  quite  costly. 

The  following  formulas  show  some  combinations,  and  give  the  approx- 
imate cost.  It  will  be  seen  that  the  required  amount,  or  more,  of  each 
food-stuff  is  present : 


HEALTHY  FOODS. 


27 


Class  I. —  Very  cheap  daily  rations  without  meat. 
No.  I. 

Proteids,        Fats.     Carbo-hydrates.  Cost. 

Oz.  Oz.  Oz.  Cts. 

26  oz.  bread 1.82  0.13  14.35  5  at  5  cts.  per  loaf. 

2  oz.  oatmeal 0.29  0,12  1.30  ^  at  4  cts.  per  lb. 

I  pt.  of  milk 0.54  0.57  0.76  3  at  6  cts.  per  qt. 

1  oz.  sugar 0.94  ^  at  8  cts.  per  lb. 

24  oz.  potatoes 0.48  4.96        i^  at  60  cts.  per  bush. 

4  oz.  beans 0.92        0.08        2.14         I  at  4  cts.  per  lb. 

2  oz.  lard 1.98  i^  at  10  cts.  per  lb. 

4.05         2.88       24.45         12I 


No.  2. 


26  oz.  bread 1.82 

2  oz.  fat  cheese 0.50 

I  pt.  milk 0.54 

16  oz.  potatoes 0.32 

4  oz.  beans 0.92 

I  oz.  lard 

I  oz.  sugar   

3  5-0Z.  cups  tea 

4.10 


0.13 

'^\-lS 

0.58 

0.04 

0.57 

0.76 

3-31 

0.08 

2.14 

0.99 

0.94 


2.35     21.54 


5  at  5  cts.  per  loaf, 
i^  at  12  cts.  per  lb. 
3  at  6  cts.  per  qt. 
I  at  60  cts.  per  bushel. 
I  at  4  cts.  per  lb. 
I  at  10  cts.  per  lb. 
^  at  8  cts.  per  lb. 
I  at  75  cts.  per  lb. 

13I 


No.  3. 


16  oz.  bread 1.12 

4  oz.  oatmeal 0.58 

I  pt.  milk 0.54 

I  oz.  sugar 

32  oz.  potatoes 0.64 

I  oz.  lard 

5  oz.  fat  cheese 1.25 

4.13 


0.08 

8.83 

0.24 

2.60 

0.57 

0.76 

0.94 

6.62 

099 

1.45 

O.I  I 

3-33       19- 


3  at  5  cts.  per  loaf. 

1  at  4  cts.  per  lb. 
3  at  6  cts.  per  qt. 
i  at  8  cts.  per  lb. 

2  at  60  cts.  per  bushel. 
I  at  10  cts.  per  lb. 

3I  at  12  cts.  per  lb. 


No. 


16  oz.  bread 1.12 

6  oz.  oatmeal 0.87 

I  pt.  milk 0.54 

I  oz.  sugar  

4  oz,  beans 0.92 

32  oz.  potatoes 0.64 

I  oz. lard      

3  5-0Z.  cups  tea 

4.09 


0.08 

8.83 

0.36 

3-9° 

0.57 

0.76 

0.94 

0.08 

2.14 

6.62 

0.99 


3  at  5  cts.  per  loaf. 
\h.  at  4  cts.  per  lb. 
3  at  6  cts.  per  qt. 
^  at  8  cts.  per  lb. 

1  at  4  cts.  per  lb. 

2  at  60  cts.  per  bushel. 
I  at  10  cts.  per  lb. 

I  at  Ti  cts.  per  lb. 


23.19 


28  HEALTHY  FOODS. 

No.  S. 

Proteids.       Fats.    Carbo-hydrates.  Cost. 

Oz.  Oz.  Oz.  Cts. 

26  oz.  bread 1.82        0.13       14.35         5  at  5  cts.  per  loaf. 

2  oz.  rice 0.16        0.02         1.53         i  at  8  cts.  per  lb. 

I  egg 0.12  0.12  i^  at  16  cts.  per  doz. 

I  oz.  lard 0.99  f  at  10  cts.  per  lb. 

4  oz.  beans 0.92  0.08  2.14         i  at  4  cts.  per  lb. 

4  oz.  fat  cheese i.oo  1.16  0.08        3  at  12  cts.  per  lb. 

4.02        2.50       18.10         iij 

No.  6. 

26  oz.  bread      » 1.82  0.13       14.35  5  at  5  cts.  per  loaf. 

I  oz.  macaroni 0.09  0.76  li  at  20  cts.  per  lb. 

4  oz.  beans 0.92  0.08        2.14  i  at  4  cts.  per  lb. 

32  oz.  potatoes 0.64  6.62  2  at  60  cts.  per  bushel. 

I  oz.  lard 0.99  |  at  10  cts.  per  lb. 

4  oz.  fat  cheese i.oo  i.r6        0.08  3  at  12  cts.  per  lb. 

1  oz.  sugar 0.94  i  at  8  cts.  per  lb. 

3  5-0Z.  cups  of  tea      ...     .  i  at  75  cts.  per  lb. 

4.47        2.36      24.89        14I 

Although  the  rations  suggested  in  the  preceding  tables  do  not  contain 
meat,  they  do  contain  more  or  less  animal  food,  and  are  healthy.  How- 
ever, the  writer  would  not  recommend  one  to  adhere  constantly  to  them, 
as  some  meat,  while  not  necessary  to  health,  does  undoubtedly  increase 
bodily  vigor. 

The  small  amount  of  really  nutritive  matter  in  tea  is  not  considered, 
and  the  reader  is  referred  to  the  articles  "  Tea  "  and  "  Coffee"  for  a  true 
explanation  of  the  food  values  of  these  drinks. 

It  will  be  seen  that  among  vegetable  foods  in  common  use,  oatmeal, 

beans,  and  potatoes  are  the  cheapest.     Since  the  prices  vary  so  greatly, 

not  only  at  different  tiines,  but  in  different  parts  of  the  country  at  the 

same  time,  the  price  at  which  the  computation  is  made  is  given  in  each 

instance ;  and  if  the  prevailing  price  differs  from  that  given,  any  one  can 

ascertain  the  change  that  would  be  produced  in  the  total  cost  of  the  daily 

rations. 

Class  II. —  Very  cheap  daily  rations  with  meat. 

No.  I. 

Proteids.      Fats.    Carbo-hydrates.  Cost. 

Oz.  Oz.  Oz.  Cts. 

26  OZ.  bread 1.82        0.13       14.35         5  at  5  cts.  per  loaf. 

2  oz.  codfish 1.60        0.02  I J  at  10  cts.  per  lb. 

20Z.  lard 1.98  I  ^  at  10  cts.  per  lb. 

16  oz.  potatoes 0.32                       3.31  i  at  60  cts.  per  bushel. 

I  pt.  milk 0.54        0.57        0.76  3  at  6  cts.  per  qt. 

I  oz.  sugar 0.94  d  at  8  cts.  per  lb. 

3  5-0Z.  cups  tea I  at  75  cts.  per  lb. 

4.28        2.70       19.36        13  cts. 


HEALTHY  FOODS. 
No.  2. 

Proteids.  Fats.   Carbo-hydrates 

Oz.  Oz.  Oz. 

1 6  oz.  bread 1.12  0.08        8.83 

I  oz.  codfish 0.80  o.oi 

1  oz.  lard 0.99 

32  oz.  potatoes 0.64  6.62 

2  oz.  bacoa       0.29  0.75 

4  oz.  beans 0.92  0.08        2.14 

I  pt.  milk 0.54  0.57        0.76 

I  oz.  sugar 0.94 

3  5-ounce  cups  tea      .... 

4.31  2.48      19.29 


29 


Cost. 


Cts. 

3  at  5  cts.  per  loaf. 
t  at  10  cts.  per  lb. 

1  at  10  cts.  per  lb. 

2  at  60  cts.  per  bushel, 
i^  at  10  cts.  per  lb. 

I  at  4  cents  per  lb. 

3  at  6  cts.  per  qt. 
i  at  8  cts.  per  lb. 

X  at  75  cts.  per  lb. 


No.  3. 


26  oz.  bread 1.82 

2  oz.  oatmeal 0.29 

I  pt.  milk 0.54 

1  oz.  sugar 

2  oz.  codfish 1.60 

8  oz.  potatoes 0.16 

2  oz, lard      

3  5-0Z.  cups  tea 

4.41 


0.13 

14-35 

0.12 

1.30 

0.57 

0.76 

0.94 

0.02 


1. 6s 


2.82       19.00 


5  at  5  cts.  per  loaf, 
i  at  4  cts.  per  lb. 
3  at  6  cts.  per  qt. 
J  at  8  cts.  per  lb. 
\\  at  10  cts.  per  lb. 
h,  at  60  cts.  per  bushel. 
I J  at  10  cts.  per  lb. 
I  at  75  cts.  per  lb. 

13 


No.  4. 

26  oz.  bread 1.82  0.13       14.35 

1  oz.  codfish 0.80  o.oi 

2  oz.  lard i  .98 

6  oz.  beans 1.38  0.12         3.21 

2  oz.  fat  cheese 0.50  0.58        0.04 

I  pt.  milk .-    0.54  0.57        0.76 

I  oz.  sugar 0.94 

3  s-oz.  cups  tea 

5.04  3.39      19.30 


5  at  5  cts.  per  loaf. 
%  at  10  cts.  per  lb. 
li  at  10  cts.  per  lb. 
i^  at  4  cts.  per  lb. 
^  at  12  cts.  per  lb. 
3  at  6  cts.  per  qt. 
i  at  8  cts.  per  lb. 
I  at  T^)  cts.  per  lb. 


No. 

26  oz.  bread 1.82 

2  oz.  fat  cheese 0.50 

2  oz.  bacon 0.29 

4  oz.  beans 0.92 

I  pt.  milk 0.54 

I  oz.  sugar   

3  8-oz.  cups  coffee 

4.07 


0.13 

14-35 

0.58 

0.04 

0.75 

0.08 

2.14 

0.57 

0.76 

0-94 

2. II 

18.23 

5  at  5  cts.  per  loaf. 
\h.  at  12  cts.  per  lb. 
i^  at  12  cts.  per  lb. 

1  at  4  cts.  per  lb. 
3  at  6  cts.  per  qt. 
i  at  8  cts.  per  lb. 

2  at  27  cts.  per  lb. 


30  HEALTHY  FOODS. 

No.  6. 

Proteids.  Fats.  Carbo-hydrates 
Or.  Oz.  Oz. 

26  oz.  bread 1.82  0.13      14.35 

2  oz,  codfish 1.60  0.02 

1  oz.  bacon 0.14  0.37 

2  oz.  lard 1.98 

16  oz.  potatoes 0.32  3.31 

i  pt.  milk 0.27  0.28        0.38 

I  oz.  sugar 0.94 

3  8-oz.  cups  coffee      .... 

4.15  2.78      18-98        13^ 


Cost. 

Cts. 
5  at  5  cts.  per  loaf. 
I  i  at  10  cts.  per  lb. 
I  at  12  cts.  per  lb. 
\\  at  10  cts.  per  lb. 

1  at  60  cts.  per  bushel, 
li  at  6  cts.  per  qt. 
i  at  8  cts.  per  lb. 

2  at  27  cts.  per  lb. 


Class  III. — Moderately  cheap  daily  rations. 
No.  I. 

Proteids.        Fats.  Carbo-hydrates.  Cost. 

O2.  Oz.  Oz.  Cts. 

16  oz.  bread 1.12  0.08  8.83  3  at  5  cts.  per  loaf. 

8  oz.  beef  (very  fat)   ....  1.36  2.12  8  at  16  cts.  per  lb. 

32  oz.  potatoes 0.64  6.62  2  at  60  cts.  per  bushel. 

2  oz.  oatmeal 0.29  0.12  1. 01  i  at  4  cts.  per  lb. 

li  pt.  milk 0.81  0.85  1. 14  4i  at  6  cts.  per  qt. 

I  oz.  sugar 0.94  i  at  8  cts.  per  lb. 

4.22         3.17       18.54         i8i 


No. 

26  oz.  bread 1.82 

8  oz.  beef  (moderately  fat)  .     .  1.68 

16  oz.  potatoes 0.32 

li  pt.  milk 0.81 

I  oz.  butter 

4-63 


0.13 

14-35 

0.45 

3-31 

0.85 

1. 14 

0.83 

5  at  5  cts.  per  loaf. 
9  at  18  cts.  per  lb. 
I  at  60  cts.  per  bushel. 
4i  at  6  cts.  per  qt. 
I i  at  24  cts.  per  lb. 


2.26       18.80        21 


No.  3. 

26  oz.  bread 1.82         0.13  14.35 

4  oz.  mutton  (very  fat)    .     .     .     0.60         1.44 

4  oz.  beans 0.92         0.08  2.14 

I  qt.  milk 1.08         1.14  1.52 

4.42         2.79  18.01 


5  at  5  cts.  per  loaf. 
4  at  16  cts.  per  lb. 
I  at  4  cts.  per  lb. 

6  at  6  cts.  per  qt. 

16 


No.  4. 

26  oz.  bread 1.82        0.13  14.35 

8  oz.  mutton  (moderately  fat)    .     1.36        0.48 

32  oz.  potatoes 0.64  6.62 

i  pt.  milk 0.27         0.28  0.38 

I  oz,  sugar 0.94 


5  at  5  cts.  per  lb. 
9  at  18  cts.  per  lb, 
2  at  60  cts.  per  bushel 
li  at  6  cts.  per  qt. 
i  at  8  cts.  per  lb. 


HEALTHY  FOODS.  3 1 

Proteids,  Fats.  Carbo-hydrates.                    Cost. 

Oz.             Oz.  Oz.  Cts. 

2  oz.  butter 1.66  3  at  24  cts.  per  lb. 

3  8-oz.  cups  coffee      ....  2  at  27  cts.  per  lb. 

4.09  2.5s  22.29        23 

No.  5. 

26  oz.  bread 1.82  0.13  14.35        5  at  5  cts.  per  loaf. 

4  oz.  pork  (lean) 0.80  0.28  3  at  12  cts.  per  lb. 

2  oz.  fat  cheese 0.50  0.58  'i  at  12  cts.  per  lb. 

32  oz.  potatoes 0.64  6.62        2  at  60  cts.  per  bushel. 

i  pt.  milk 0.27  0.28  0.38         i^  at  6  cts.  per  qt. 

1  oz.  butter 0.83  id  at  24  cts.  per  lb. 

3  8-oz.  cups  coffee      ....  2  at  27  cts.  per  lb. 

4.03  2.10  21.35        i6d 

No.  6. 

26  02.  bread 1.82  0.13  14.35        5  at  5  cts.  per  loaf. 

2  oz.  sausage  (best  quality)      .    0.57  0.80  \\  at  12  cts.  per  lb. 

2  oz.  oatmeal 0.29  0.12  1.30        i  at  4  cts.  per  lb. 

4  oz.  beans 0.92  0.08  2.14         i  at  4  cts.  per  lb. 

I  oz.  bacon 0.14  0.37  I  at  12  cts.  per  lb. 

I  pt.  milk 0.54  0.57  0.76        3  at  6  cts.  per  qt. 

I  oz.  butter 0.83  i|  at  24  cts.  per  lb. 

I  oz.  sugar 0.94        i  at  8  cts.  per  lb. 

3  5-0Z.  cups  tea I  at  75  cts.  per  lb. 

4.28  2.90  1949         I4i 


Class  IV. — More  expensive  daily  rations. 
No.  I. 

Proteids.         Fats.  Carbo-hydrates.  Cost. 

Oz.              Oz.  Oz.                                   Cts. 

16  OZ.  bread 1.12        0.08  8.83  3  at  5  cts.  per  loaf. 

2  eggs 0.24        0.24  4  at  24  cts.  per  doz. 

2  oz.  butter 1.66  4  at  32  cts.  per  lb. 

I  qt.  milk 1.08         1.14  1.52  8  at  8  cts.  per  qt. 

I  oz.  bacon        0.14        0.37  I  at  12  cts.  per  lb. 

I  oz.  string  beans 0.03  0.06  2  at  32  cts.  per  lb. 

8  oz.  mutton 1.36        0.48  9  at  18  cts.  per  lb. 

32  oz.  potatoes 0.64  6.62  2  at  60  cts.  per  bushel 

1  oz.  sugar 0.94  i  at  8  cts.  per  lb. 

\  oz.  dried  fruit 0.02  0.55  i^  at  20  cts.  per  lb. 

4.63        3.97  18.52  34i 

No.  2. 

16  oz.  bread 1.12        0.08  8.83  3  at  5  cts.  per  loaf. 

2  oz.  oatmeal 0.29        0.12  1.30  ^  at  4  cts.  per  lb. 

2  oz.  sugar 1.88  I  at  8  cts.  per  lb. 


32  HEALTHY  FOODS. 

Proteids.  Fats.   Carbo-hydrates 

Oz.  Oz,              Oz. 

I  pt.  milk 0.54  0.57        0.76 

1  oz.  macaroni 0.09  0.76 

80Z.  beef 1.68  0.44 

32  oz.  potatoes 0.64  6.62 

2  oz.  salmon 0.32  o.ii 

2  oz.  butter i-66 

3  8-oz.  cups  coffee      .... 

4.68  2  98      20.15 

No.  3. 

200Z.  bread 1.40  o.io      11.04 

4  oz.  beef 0.84  0.22 

2  oz.  butter 1.66 

2  oz.  fat  pork 0.29  0.75 

2  oz.  beans        0.46  0.04        1.07 

2  oz.  starch 1.67 

2  oz.  sugar i  .88 

2  oz.  dried  fruit 0.05  i.il 

8  oz.  potatoes 0.16  1.65 

8  oz.  lean  mutton 1.36  0.48 

3  8-oz.  cups  coffee      .... 

i  pt.  milk 0.27  0.28        0.38 

4.83  3.53       18.80 

No.  4. 

20  oz.  bread 1.40  o.io       11.04 

2  oz.  oatmeal 0.29  0.12         1.30 

1  qt.  milk i.o8  1.14        1.52 

2  oz.  sugar i  '88 

2  oz.  butter 1.66 

2  oz.  mackerel 0.46  0.13 

8  oz.  chicken 1.86  0.19 

16  oz.  potatoes 0.32  3.30 

8  oz.  fruit  (as  apple  sauce)  .     .  0.80 

5.41  3.34       19.84 

No.  5. 

26  oz.  bread      ......     1.82  0.13       14.35 

2  oz.  sausage 0.57  0.80 

2  oz.  butter 1.66 

8  oz.  lean  beef 1.68  0.08 

16  oz.  potatoes 0.32  3.30 

2  oz.  macaroni 0.18  1.53 

1  qt.  milk 1.08  1. 14         1.52 

2  oz.  sugar i'88 

3  8-oz.  cups  coffee      .     .     . 

5.65  3.81        22.58 


Cost. 
Cts. 

3  at  6  cts.  per  qt. 

1  i  at  20  cts.  per  lb- 
9  at  18  cts.  per  lb. 

2  at  60  cts.  per  bushel, 
li  at  20  cts.  per  lb. 

4  at  32  cts.  per  lb. 
2  at  27  cts.  per  lb. 

27i 


4  at  5  cts.  per  loaf. 
4i  at  18  cts.  per  lb. 
4  at  32  cts.  per  lb. 
i^  at  12  cts.  per  lb. 
i  at  4  cts.  per  lb. 
2  at  16  cts.  per  lb. 

1  at  8  cts.  per  lb. 
2i  at  20  cts.  per  lb. 

i  at  60  cts.  per  bushel. 
8  at  16  cts.  per  lb. 

2  at  27  cts.  per  lb. 
I  i  at  6  cts.  per  qt. 

32 

4  at  5  cts.  per  loaf, 
i  at  4  cts.  per  lb. 
6  at  6  cts.  per  qt. 
I  at  8  cts.  per  lb. 
4  at  32  cts.  per  lb. 
i^  at  12  cts.  per  lb. 
12^  at  25  cts.  per  lb. 
I  at  60  cts.  per  bushel. 
I  at  $1  per  bushel. 


5  at  5  cts.  per  loaf. 
2  at  16  cts.  per  lb. 
4  at  32  cts.  per  lb. 
9  at  18  cts.  per  lb. 

I  at  60  cts.  per  bushel. 
2i  at  20  cts.  per  lb. 

6  at  6  cts.  per  qt. 

1  at  8  cts.  per  lb. 

2  at  27  cts.  per  lb. 

32i 


HEALTHY  FOODS.  33 

No.  6. 
Proteids.        Fats.    Carbo-hydrates.  Cost. 

Oz.  Oz.  Oz.  Cts. 

26  oz,  bread 1.82  0.13  14.35         5  at  5  cts.  per  loaf. 

2  eggs 0.24  0.24  4  at  24  cts.  per  doz. 

2  oz.  butter 1.66  4  at  32  cts.  per  lb. 

8  oz.  lean  beef 1.68  0.08  9  at  18  cts.  per  lb. 

2  oz.  beans        .     .     .     .     .     .  0.46  0.04  1.07        ^  at  4  cts.  per  lb. 

I  oz.  bacon 0.14        0.37  I  at  12  cts.  per  lb. 

16  oz.  potatoes 0.32  3.30         i  at  60  cts.  per  bushel. 

I  oz.  sugar 0.94        ^  at  S  cts.  per  lb. 

I  pt.  milk 0.54         0.57         0.76         3  at  6  cts.  per  qt. 

3  8-oz.  cups  coffee       ....  2  at  27  cts.  per  lb. 

5.20        3.09      20.42        29I 

To  tne  cost  of  the  raw  food,  as  given  in  the  preceding  tables,  is  to  be 
added  the  cost  of  cooking,  fuel,  keeping  the  table,  and  of  furnishing  sea- 
soning, such  as  salt,  pepper,  and  mustard.  Where  six  or  more  persons 
eat  together,  the  cost  of  the  above  items,  including  enough  to  pay  the 
wages  of  the  cook  and  waiters,  is  from  35  to  50  cents  per  week  for  each 
boarder.  This  increases  the  daily  cost  of  board  by  from  5  to  7  cents 
above  the  figures  given  in  the  tables. 

ANIMAL   FOODS. 

MEATS GENERAL  PROPERTIES. 

A  large  proportion  of  our  daily  food  consists  of  material  derived  from 
the  animal  world.  Other  animals  take  vegetable  food  and  build  it  up, 
so  that  it  approximates  in  physical  and  chemical  properties  the  flesh  of 
man.  Of  the  foods  thus  derived  from  the  animal  kingdom,  meat  is  one 
of  the  most  important.  Meat  consists  of  different  food-stuffs,  as  water, 
mineral  salts,  albumen,  and  fat.  On  an  average,  100  parts  of  beef  consist 
of  72  parts  of  muscle,  8  parts  of  fat,  and  20  parts  of  bone  (including  car- 
tilage and  tendon).  The  age  of  the  animal,  and  the  manner  in  which  it 
has  been  fitted  for  market,  have  a  marked  effect  upon  the  composition  of 
the  flesh.  Veal  contains  3  per  cent,  more  of  water,  and  a  corresponding 
amount  of  solid  substance,  than  lean  beef.  Fat  beef  may  contain  as  much 
as  10  per  cent,  less  of  water  than  lean  beef.  The  same  is  true  of  the  dif- 
ference between  mutton  and  lamb.  Of  all  the  kinds  of  flesh  eaten,  fat 
bacon  contains  the  least  amount  of  water.  The  average  per  cent,  of 
water  in  bacon  is  60,  while  that  in  lean  beef  is  75.  The  flesh  of  wild 
fowl,  chickens,  arid  pigeons  furnishes  on  an  average  77  per  cent,  of  water. 
Fish  is  especially  rich  in  water,  the  carp  yielding  80  per  cent.  The  fat 
in  lean  beef,  veal,  and  mutton  may  be  as  low  as  from  i  to  i  J  per  cent., 
while  that  of  fat  beef  is  14,  of  fat  mutton  9,  veal  6,  and  bacon  24.  Along 
with  these  variations  in  the  amounts  of  water  and  fat  there  are  corre- 
sponding changes  in  the  quantity  of  nitrogenous  material.     As  a  rule. 


34  HEALTHY  FOODS. 

fish  is  poorest  in  nitrogenous  substance,  the  per  cent,  in  carp  and  salmon 
being  13,  in  pickerel  15  ;  fat  veal,  mutton,  and  bacon,  15  ;  fat  beef,  16 ; 
lean  beef,  22. 

The  following  rules  may  govern  us  in  the  selection  of  meats : 

Good  beef  has  a  reddish-brown  color,  and  contains  no  clots  of  blood. 
Well  nourished  beeves  furnish  a  flesh  which  while  raw  is  marbled  with 
spots  of  white  fat ;  it  is  firm  and  compact.  Old,  lean  animals  furnish  a 
flesh  which  is  tough,  dry,  and  dark  ;  the  fat  is  yellow.  Veal  is  slightly 
reddish,  and  has  tender,  white  fibi'es.  The  fat  is  not  distributed  through 
the  lean,  as  in  beef.  The  same  is  true  of  mutton.  In  well  nourished 
animals,  white  fat  accumulates  along  the  borders  of  the  muscles. 

Pork  is  rose-red,  and  has  fat  distributed  through  the  muscle.  The  lard 
as  white,  and  lies  in  heavy  deposit  under  the  skin.  The  flesh  of  an  old 
boar  is  dark,  and  often  has  an  unpleasant  odor  and  taste. 

Good  beef  is  not  of  a  pale  pink  color,  and  such  a  color  indicates  that 
the  animal  was  diseased.  Good  beef  does  not  have  a  dark  purple  hue, 
for  this  color  is  evidence  that  the  animal  has  not  been  slaughtered,  but 
has  died  with  the  blood  in  its  body,  or  has  suffered  from  some  acute  feb- 
rile affection. 

Good  beef  has  no,  or  but  little,  odor  ;  or  if  any  odor  is  perceptible  it 
is  not  disagreeable.  In  judging  as  to  the  odor  of  meat,  pass  a  clean 
knife,  which  has  been  dipped  in  hot  water,  through  it,  and  examine  sub- 
sequently as  to  the  odor  of  the  knife.  Tainted  meat  often  gives  off  a 
plainly  perceptible  and  disagreeable  odor  while  being  cooked. 

Good  meat  is  elastic  to  the  touch.  Meat  that  is  wet  and  flabby  i^ould 
be  discarded.  It  should  not  become  gelatinous  after  being  kept  in  a  cool 
place  for  two  days,  but  should  remain  dry  on  the  surface  and  firm  to  the 
touch. 

The  flesh  of  young  animals  is  more  tender  than  that  of  tlie  adult,  but 
experiment,  as  well  as  experience,  has  shown  that  the  former  is  less  easily 
digested.  For  instance,  veal  and  lamb  are  less  easily  digested,  and  tax 
the  stomach  of  the  dyspeptic  more  than  beef  and  mutton.  Dr.  Smith 
has  shown  that  this  is  largely  due  to  the  fact  that  the  flesh  of  young  ani- 
mals cannot  be  perfectly  masticated.  The  tissues  of  the  young  animal 
are  less  stimulating,  less  nutritious,  and  more  gelatinous  than  the  tissues 
of  the  adult  animal.  On  the  other  hand,  it  is  well  known  that  an  animal 
may  be  so  old  and  poorly  nourished  that  its  flesh  well-nigh  defies  both 
mastication  and  digestion.  The  common  breeds  of  cattle  are  best  fitted 
for  the  market  at  the  age  of  7  years  ;  the  better  breeds  earlier. 

It  makes  a  difference  whether  the  special  meat  be  served  in  or  out  of 
season.  Beef  is  in  highest  season  in  the  early  months  of  winter,  after 
the  animal  has  been  furnished  abundant  pasturage,  though  not  absolutely 
out  of  season  at  any  time  of  the  year.  Fresh  pork  is  wholly  out  of  sea- 
son during  the  hot  months  of  summer.  Christison  found  in  salmon,  be- 
fore the  spawning  season,  18.5  per  cent,  of  fat  and  39  per  cent,  of  solids  ; 
after  the  spawning  season,  i  j^er  cent,  of  fat  and  20  per  cent,  of  solids. 

In  most  cases,  animals  are  fattened  for  the  table.     Some  fat  is  desira- 


HEAL  THY  FOODS.  3  5 

ble,  as  it  renders  the  meat  more  juicy,  and  develops  an  agreeable  flavor. 
But  the  process  of  fattening  is  often  carried  too  far.  Fat  should  be  taken 
in  a  finely  divided  state,  for  M^hen  swallowed  in  lumps  it  is  well-nigh 
indigestible.  Many  a  child,  which  has  been  reproved  for  refusing  to  eat 
fat  meat,  will  readily  take  the  same  amount  of  fat,  as  butter,  spread  upon 
bread.  The  manner  in  which  the  animal  has  been  killed  affects  the 
meat.  Slaughtering  is  usually  so  conducted  as  to  remove  as  much  as 
possible  of  the  blood.  Either  death  is  produced  by  the  withdrawal  of 
blood,  or  the  blood  is  withdrawn  as  soon  as  possible  after  death.  The 
removal  of  the  blood  enables  the  meat  to  be  kept  with  more  ease  ;  it  also 
improves  the  flavor. 

In  warm  countries  meat  is  often  cut  from  the  animal  and  cooked  as 
soon  as  death  is  produced,  and  before  rigor  mortis  (the  stiffness  of  death) 
sets  in.  While  the  rigor  is  on,  the  meat  is  more  difficult  of  mastication 
and  digestion.  In  temperate  latitudes  the  flesh  is  usually  kept  until  this 
rigidity  naturally  passes  off.  This  may  be  aided  by  pounding  the  meat 
after  it  has  been  cut  into  thin  pieces.  With  us,  the  only  animals  which 
are  cooked  before  rigor  sets  in  are  fish,  frogs,  some  mollusks,  frequently 
domestic  fowls,  and  sometimes  wild  game. 

The  flesh  of  wild  animals  is  richer  in  nitrogen  and  flavor,  and  contains 
less  fat,  than  that  of  the  same  species  kept  in  domestication. 

Meat  which  has  been  frozen  decomposes  easily  after  being  thawed  out, 
and  when  cooked  it  is  dry  and  insipid. 

The  ancient  Egyptians  and  Chaldeans  were  acquainted  with  the  fact 
that  the  flesh  of  diseased  animals  might  harmfully  affect  those  eating  of 
it,  and  among  them  the  use  of  such  flesh  as  food  was  prohibited.  The 
strictest  measures  w^ere  taken  to  see  that  the  meat  furnished  their  kings 
and  priests  was  obtained  from  healthy  animals.  Even  during  the  dark 
ages  this  prohibition  of  the  use  of  flesh  from  diseased  animals  continued. 
During  the  eighteenth  century,  however,  it  was  found  that  the  inhab- 
itants of  besieged  towns  ate  of  such  food  when  starvation  threatened 
them,  and  without  any  marked  detriment  to  health.  The  flesh  of  a  dis- 
eased animal  does  not  necessarily  convey  the  malady  to  the  consumer ; 
but  in  order  to  prevent  such  transmission  the  cooking  must  be  thorough^ 
That  phthisis  (consuinption)  may  be  imparted  to  dogs  by  feeding  them 
upon  tubercular  flesh  has  been  proven  experimentally.  Dr.  Livingston 
states  that  the  use  of  the  flesh  of  animals  afflicted  with  pleuro-pneumonia 
produces  carbuncle.  In  Germany  and  France  many  cases  of  anthi'ax  or 
malignant  pustule  in  man  have  arisen  from  partaking  of  the  flesh  of  ani- 
mals with  this  disease.  The  flesh  of  sheep  with  the  small-pox,  and  of 
oxen  with  the  cattle  plague,  has  affected  those  partaking  of  it.  Then 
there  are  the  parasites,  trichinae,  cysticerci  (in  "measly"  meat),  and 
echino-cocci  (flukes),  which  may  be  transmitted  to  man.  If  every  part 
of  the  meat  be  raised  to  a  temperature  of  i6o°Fahr.  during  cooking, 
these  parasites  are  destroyed  ;  but  if  the  blood-red  juices  exude  from  the 
interior  of  the  piece  of  meat  on  being  cut,  the  parasites,  if  present,  may 
still  retain  their  vitality. 


36  HEALTHY  FOODS. 

The  eating  of  the  flesh  of  diseased  animals  is  admissible  only  when  no 
better  food  can  be  secured,  and  when  starvation  threatens.  The  sale  of 
such  meat  is  prohibited  by  law,  and  any  one  guilty  of  such  an  outrage 
should  be  punished  to  the  fullest  extent. 

The  flesh  of  a  healthy  animal  may  become  poisonous  from  partial 
decomposition.  By  the  jDutrefaction  of  albuminous  substances,  certain 
organic  poisons  are  generated.  The  symptoms  produced  resemble  those 
of  severe  cholera  morbus,  and  a  fatal  termination  is  not  infrequent. 
These  cases  most  frequently  arise  from  eating  sausage  and  canned  meats, 
though  they  may  be  due  to  any  meat  which  is  partly  putrid. 

Gerlach,  director  of  the  Royal  Veterinary  School  at  Berlin,  gives  the 
following  list  of  meats  which  should  not  be  eaten  : 

(i)  The  flesh  of  all  animals  which  have  died  of  internal  diseases,  or 
which  have  been  killed  while  suffering  from  such  diseases,  and  of  healthy 
animals  which  have  been  killed  by  over-driving ; 

(2)  The  flesh  of  animals  with  contagious  diseases  which  maybe  trans- 
mitted to  man  ; 

(3)  The  flesh  of  animals  which  have  been  poisoned  ; 

(4)  The  flesh  of  animals  with  severe  infectious  diseases,  such  as  blood 
poisoning ; 

(5)  Flesh  which  contains  parasites  that  may  be  transmitted  to  man  ; 

(6)  All  putrid  flesh. 

METHODS    OF    COOKING   MEAT. 

In  boiling  meat,  if  it  is  desired  to  retain  the  juices,  the  piece  should  be 
large,  and  should  be  placed  at  once  in  boiling  water,  and  the  boiling 
continued  for  five  minutes.  Then  the  temperatui^e  of  the  water  should 
be  allowed  to  fall  to  160°  Fahr.,  at  which  point  it  should  be  maintained 
until  the  meat  is  done.  The  boiling  water  coagulates  the  outside  of  the 
meat,  and  thus  prevents  the  escape  of  the  juices.  If  the  temperature  be 
kept  at  or  near  the  boiling  point  throughout  the  process,  the  flesh  shrinks, 
becomes  tough,  loses  in  flavor,  and  is  finally  digested  with  much  diffi- 
culty. 

On  the  other  hand,  if  the  object  of  the  boiling  is  to  inake  a  good  soup, 
the  meat  should  be  cut  into  small  pieces,  placed  in  cold  water,  and  the 
temperature  gradually  raised  to  from  150°  to  160°  Fahr.  Chicken  broth 
is  the  most  nutritious  ;  mutton  next ;  while  beef  makes  a  very  weak  broth. 
By  boiling,  meat  loses,  as  a  rule,  from  25  to  30  per  cent,  of  its  weight. 

In  roasting,  the  oven  should  at  first  be  very  hot ;  then  it  should  be 
cooled  down,  and  the  process  continued  at  a  low  temperature.  Since 
the  heat  applied  to  every  portion  of  the  outside  of  the  meat  cannot  be  so 
uniform  in  roasting  as  in  boiling,  the  loss  is  usually  greater  in  the  former 
than  in  the  latter. 

Stewed  meat  is  that  roasted  in  its  own  juices.  The  meat  is  cut  into 
small  pieces,  and  the  cooking  should  be  carried  on  at  as  low  a  tempera- 
ture as  possible.     The  extracted  matter  should  be  served  with  the  meat. 


HEALTHY  FOODS.  ^^ 

Often  vegetables  are  stewed  with  the  meat,  thus  improving  the  flavor  of 
the  former. 

Proper  cooking  renders  the  meat  more  agreeable  to  the  senses  of  sight, 
smell,  and  taste,  and  thus  through  the  nervous  system  it  stimulates  the 
flow  of  the  digestive  fluids.  One  of  the  most  fruitful  sources  of  error  in 
the  cooking  lies  in  using  too  high  a  temperature. 

BRIEF   CONSIDERATION    OF    THE    MEATS    IN    COMMON   USE. 

Beef.  Among  all  civilized  people  beef  is  regarded  as  the  principal 
animal  food.  By  common  consent  we  admit  that  beef  is  more  nutritious 
than  any  other  kind  of  flesh.  This  universal  opinion  is  supported  by  the 
investigations  of  science.  There  is  a  larger  proportion  of  nutritious 
material  m  beef  than  in  the  flesh  of  the  sheep  or  hog.  Beef  is  of  closer 
texture,  and  is  fuller  of  red-blood  juices.  It  is  richer  in  flavor  than  the 
flesh  of  any  other  domestic  animal,  and  a  smaller  amount  of  it  will  sat- 
isfy hunger.  Siegert  gives  the  following  figures,  showing  the  average 
per  cent,  composition  of  the  flesh  taken  from  different  parts  of  a  lean  and 
a  fat  ox : 


Lean  Ox. 

Fat  Ox. 

Neck. 

Sirloin. 

Shoulder. 

Neck. 

Sirloin. 

Shoulder. 

Water, 

77-5 

77-4 

76.5 

73  5 

634 

50.S 

Fat, 

0.9 

I.I 

1-3 

5.8 

16.7 

34.0 

Muscle, 

20.4 

20.3 

21.0 

19.5 

18.8 

I4.S 

On  an  average,  ()^  per  cent,  of  the  live  weight  of  an  ox  may  be  con- 
verted into  salable  meat,  the  exact  proportion  varying  with  the  degree 
to  which  the  animal  has  been  fattened.  The  greater  the  amount  of  fat, 
the  less  the  proportion  of  bone  and  other  ^vaste. 

Not  only  does  beef  from  different  animals  differ  in  composition,  flavor, 
and  digestibility,  but  that  from  various  parts  of  the  same  animal  varies. 
The  flesh  from  the  different  parts  of  the  carcass  is  divided  into  the  fol- 
lowing four  classes,  according  to  quality  : 

Class  I.  Porterhouse,  sirloin,  and  best  cuts  from  the  rump  :  Price  per 
pound,  15  cents. 

Class  II.  Round,  shoulder,  ribs,  top  ribs,  ffank  steak,  plate,  and  skirt, 
12\  cents. 

Class  III.  Best  parts  of  neck,  brisket,  and  ffank,  S  cents. 

Class  IV.  Poorer  parts  of  neck,  ffank,  and  brisket,  7  cents. 

Pieces  of  shank  and  bone  are  usually  sold  by  the  piece,  and  not  by  the 
pound.  The  prices  vary  in  different  sections  of  the  country  and  at  differ- 
ent times,  but  the  writer  gives  the  above  figures  for  the  purpose  of  show- 
ing the  difference  in  value  of  different  parts  from  the  same  animal. 

Veal.  In  many  sections  of  the  country  calves  of  all  ages  are  slaugh- 
tered. In  some  cities,  as  in  Boston,  the  killing  of  a  calf  under  one 
month  of  age  for  food  is  prohibited.  It  would  be  well  if  this  law,  or  a 
more  extensive  one,  should  be  enforced  all  over  the  country.  Veal  is  too 
•often  used  simply  as  a  dish  to  please  the  taste.     As  has  been  remarked, 


38  HEALTHY  FOODS. 

it  is  not  nearly  so  nutritious  as  beef,  and  is  much  more  difficult  of  diges- 
tion. Some  persons  are  wholly  vmable  to  digest  veal,  and  when  they 
eat  of  it,  it  acts  as  a  foreign  body  in  the  intestines,  and  causes  griping 
and  diarrhoea.  Dr.  Smith  states  that  it  is  more  easy  of  digestion  when 
well  roasted  or  broiled  than  when  boiled.  The  time  required  for  the 
digestion  of  veal  is  five  hours  or  more,  while  beef  is  digested  in  from  two 
and  a  half  to  three  hours. 

The  mode  of  killing  often  practised  in  this  case  has  a  special  influence 
on  the  nutritive  value  of  the  food.  Veal  is  bleached  by  repeatedly  bleed- 
ing the  animal  for  some  days,  and  at  last  allowing  it  to  bleed  to  death. 
The  bones  of  calves  contain  much  animal  matter,  and  for  this  reason 
they  are  used  for  the  production  of  gelatine  ;  and  calves'  feet  are  selected 
for  the  preparation  of  jellies,  which  are  often  very  acceptable  to  the  sick. 

Mutton.  This  is  more  easily  digested  than  beef,  though  in  a  healthy 
man  no  marked  difference  would  be  observed,  since  in  the  stomach  of 
such  a  man  there  arises  no  inconvenience  from  the  digestion  of  beef. 
However,  mutton  will  be  found  to  tax  the  stomach  of  the  dyspeptic  less 
than  beef  does,  and  mutton  broth  is  both  acceptable  and  valuable  to  a 
person  suffering  from  dysentery  or  kindred  affections  of  the  bowels.  But 
mutton  is  not  so  nvitritious  as  beef. 

In  dressing  a  mutton,  the  w^oolly  coat  should  not  be  allowed  to  touch 
the  flesh.  There  is  quite  a  perceptible  difference  in  the  ffavor  of  mutton 
taken  from  a  fattened  wether,  which  has  been  for  some  time  deprived  of 
all  excess  in  his  woolly  coat,  and  of  that  taken  from  a  sheep  which  has  a 
heavy  fleece.  The  smallest  proportion  of  both  fat  and  bone  to  muscle  is 
found  in  the  leg  ;  consequently  this  is  the  most  valuable  part  of  the  ani- 
mal. 

Lamb.  This  is  not  nearly  so  nutritious  as  mutton.  The  tissue  is  soft^ 
gelatinous,  and  rich  in  water.  It  is  used  principally  on  account  of  its 
delicacy  of  flavor,  which,  however,  is  very  variable,  depending  upon  the 
breed  and  nourishment.  Lamb  should  not  be  selected  for  those  whose 
digestive  organs  are  weak. 

Pork.,  Bacon.,  and  Ham.  As  a  rule,  dried  meats  are  more  difficult  of 
digestion  than  the  same  meats  in  the  fresh  state.  Bacon  and  ham  are, 
however,  exceptions  to  this  rule,  for  when  well  cured  they  are  digested 
■with  more  ease  than  fresh  pork.  In  cold  weather,  nice  bacon  is  espe- 
cially suited  for  furnishing  a  large  amount  of  heat  by  its  oxidation  in  the 
body.  The  inhabitants  of  cold  countries  find  fatty  food  necessary  to  their 
existence. 

For  several  reasons,  the  flesh  of  the  hog  must  continue  to  form  one  of 
the  most  important  sources  of  our  food.  This  animal  can  be  fattened 
more  readily  and  at  less  cost  than  either  the  ox  or  sheep.  The  best 
breeds  of  pigs  store  up  in  their  bodies  three  times  as  much  of  the  food 
which  they  eat  as  the  ox  does.  Then  the  flesh  can  be  cured  easily  and 
preserved  indefinitely.  Again,  the  animal  multiplies  rapidly  and  reaches 
maturity  speedily. 

On  the  other  hand,  of  all  the  meats  ordinarily  eaten,  this  is  most  likely 


HEALTHY  FOODS.  39 

to  be  diseased.  "Measly"  pork  can,  as  a  rule,  be  recognized  by  the 
unaided  eye  on  close  inspection.  The  meat  is  dotted  with  grayish-white 
specks,  about  the  size  of  a  pea  ;  but  "  measly"  pork  is  often  cut  up  into 
sausage,  in  which  the  diseased  condition  escapes  recognition.  The 
"measles"  (cysticerci),  taken  into  the  stomach  of  man,  develop  into 
tape  worms.  Then  there  are  the  trichinae,  which  can  be  recognized  only 
by  the  aid  of  the  microscope.  These  little  parasites  penetrate  the  mus- 
cles of  man,  causing  great  suffering,  which  often  terminates  in  death. 
These  parasites  occur  so  frequently  in  pork  and  its  cured  products,  that 
every  one  should  always  remember  that  the  flesh  of  the  hog  should  not 
be  eaten  unless  it  has  been  thoroughly  cooked.  As  we  have  stated,  these 
parasites  are  destroyed  if  the  temperature  of  every  part  of  the  meat  be 
raised  to  160°  Fahr.  during  cooking. 

JPoxvl.  There  is  no  bird  that  may  not  be  eaten  in  case  of  necessity. 
In  other  words,  the  flesh  of  no  bird  is  in  itself  poisonous.  The  same  is 
true  of  the  eggs  of  all  birds.  It  is  true  that  cases  of  poisoning  from  eat- 
ing quails,  during  spring,  have  occurred  ;  but  the  poisoning  was  due  to 
the  buds  of  the  mountain  laurel,  upon  which  the  birds  fed.  The  flesh  of 
carnivorous  birds  is  strong  in  odor  and  in  taste,  and  would  not  form  a 
tempting  dish,  save  to  one  threatened  with  starvation.  The  light  meats 
of  birds  are  more  easily  digested,  less  rich  in  nitrogen  and  in  flavor,  than 
the  dark  meats.  Chicken  broth  is  more  nutritious  than  that  made  from 
either  mutton  or  beef,  and  is  often  of  great  value  to  the  sick. 

Pish.  Undoubtedly  the  flesh  of  some  fish  is  poisonous.  A  fish  is  said 
to  justify  suspicion  when  it  has  attained  a  size  unusual  for  one  of  its  spe- 
cies. This  popular  idea  may  have  a  grain  of  truth  in  it.  Fish  should 
be  discarded  if  the  water  in  which  it  is  being  boiled  blackens  silver.  The 
coloration  is  due  to  hydrogen  sulphide  (the  gas  of  bad  eggs) ,  and  indi- 
cates putrefactive  changes.  Decomposing  fish  has  a  pale  look,  and  its 
belly  is  bluish.  It  is  withered,  sticky  to  the  touch,  and  foul  in  odor. 
The  seller  sometimes  tries  to  hide  the  evidence  of  decomposition  by 
taking  the  eyeballs  out  and  coloring  the  gills  with  blood.  Fish  caught 
from  putrid  water  should  not  be  eaten.  Sometimes,  near  large  manu- 
facturing establishments  where  a  great  deal  of  refuse  is  thrown  into  the 
water,  the  fish  are  killed,  and  may  be  brought  to  market.  The  flesh  of 
such  fish  is  yellowish,  soft,  spongy,  and  of  foul  odor.  Fish  may  be 
divided  into  those  furnishing  white  and  those  furnishing  red  meats. 
Those  of  the  former  class,  as  the  whitefish,  are  delicate  and  easy  of  diges- 
tion, while  those  of  the  second  class  are  richer  in  nitrogen,  and  more 
stimulating.  Fish  should  not  be  left  in  the  water  after  they  are  dead, 
but  should  be  packed  in  ice. 

Fish  should  not  be  the  chief  flesh  diet  of  a  people,  because  it  is  not 
sufficiently  stimulating.  Indeed,  it  is  doubtful  if  any  class  of  people 
would  voluntarily  confine  themselves  to  such  food. 

But  the  occasional  use  of  fish  forms  a  change  which  is  both  agreeable 
and  beneficial.  There  is  no  truth  in  the  popular  idea  that  a  fish  diet  is 
especially  suited  to  the  development  of  the  brain  and  nervous  system. 


40  HEALTHY  FOODS. 

Along  with  fish  are  often  classed  certain  crustaceans,  as  the  crab  and 
lobster,  and  certain  mollusks,  as  the  oyster  and  mussel.  The  oyster  and 
mussel  are  gelatinous,  but  are  easily  masticated  and  digested.  The  lob- 
ster, crayfish,  and  crab  are  more  muscular,  and  are  somewhat  more  dif- 
ficult of  mastication  and  digestion.  The  nutritive  value  of  the  oyster  is 
not  very  great,  but  its  delicacy  of  flavor  and  ease  of  digestion  make  it  of 
great  value  to  all,  and  especially  to  the  sick.  The  raw  oyster  is  probably 
more  easily  digested  than   iie  cooked. 

The  crab  and  lobster  are  of  considerable  nutritive  value,  though,  on 
account  of  price,  they  are  used  principally  as  delicacies. 

Sausage.  The  food  value  of  sausage  depends  upon  the  substances  out 
of  which  it  is  prepared.  If  made  from  good  meat  it  forms  a  very  valu- 
able preparation,  as  by  this  means  all  the  small  bits  are  collected  and 
saved.  But  its  method  of  preparation  allows  of  the  introduction  of  poor 
grades  of  flesh,  and  of  several  adulterations. 

The  adulterations  which  have  been  found  in  sausage  are  meal,  to  in- 
crease the  bulk  and  the  profit ;  salicylic  acid  and  borax,  to  prevent 
decomposition  ;  and  a  red  coloring  matter  (fuchsin) ,  to  give  the  poorer 
quality  of  meat  a  better  color.  The  liver  sausage  (lebei-wurste  of  the 
Germans)  is  made  by  grinding  up  liver,  lungs,  kidney,  tendon,  soft  car- 
tilage, and  fat ;  sometimes  meal  is  added.  The  so-called  white  sausage, 
which  is  used  to  some  extent  in  this  country,  is  made  by  mixing  the 
crumbs  of  white  bread  with  the  meat.  Blood  or  red  sausage  consists  of 
a  mixture  of  blood,  fat,  and  flesh,  with  or  without  meal.  Pea  sausage  is 
a  well  known  preparation  in  France,  where  it  is  patented  and  warranted 
not  to  become  rancid.  It  is  of  variable  composition,  but  consists  prin- 
cipally of  ground  pease  with  meat,  and  some  presei-vative,  as  salicylic 
acid.     The  writer  does  not  know  of  its  introduction  into  this  country. 

Sausage  poisoning,  which  is  common  and  so  often  fatal  in  parts  of 
Germany,  is  fortunately  very  i"are  in  this  country,  though  a  similar  affec- 
tion from  canned  and  dried  ineats  is  becoming  too  frequent.  The  poison 
is  generated  by  partial  decoinposition.  Sausage  which  has  a  putrid  odor, 
or  rancid  taste,  or  has  greenish  or  yellow  spots  in  its  interior,  should 
not  be  eaten.  Bad  sausage,  and  other  similar  meat  preparations,  are 
usually,  in  the  interior  at  least,  soft  and  sticky,  and  when  broken  show 
small  cavities.     This  is  true  even  when  the  outside  appears  to  be  all  right. 

Meat  Extracts.  Liebig's  meat  extract,  which  is  now  so  well  known, 
is  made  by  boiling  lean  meat  with  from  eight  to  ten  times  its  volume  of 
water,  removing  the  insoluble  parts,  fat  and  albumen,  and  evaporating 
to  the  consistency  of  a  syrup.  About  thirty  pounds  of  meat  yield  one 
pound. of  extract.  Meat  extracts  are  made  on  the  largest  scale  in  South 
America,  from  cattle  which  are  wholly  worthless  for  beef. 

it  will  be  seen  that  this  extract  consists  only  of  those  constituents  of 
the  meat  which  are  soluble  in  water,  and  they  are  certain  crystallizable 
organic  bodies  and  the  inorganic  salts.  All  the  really  nutritive  j^arts 
of  the  meat  are  insoluble  in  water,  and  are  not,  therefore,  present  in 
the  extract.     Liebig's  extract  and  similar  preparations  are  agreeable  in 


HEALTHY  FOODS.  4 1 

taste  and  odor,  and  are  valuble  stimulants,  often  improving  the  appetite, 
so  that  more  valuable  foods  are  demanded  and  digested.  As  stimulants, 
they  are  of  great  value  to  the  sick  ;  but  some  other  food  should  also  be 
supplied.  A  German  deprived  tw^o  dogs  of  all  solid  food,  giving  one 
only  w^ater,  and  the  other  meat  extract.  The  one  furnished  with  the 
extract  lost  flesh  more  rapidly  than  the  other,  and  died  first. 

Beef -Tea.  This  should  be  prepared  as  follow^s :  Cut  the  beef-steak 
into  fine  pieces.  Put  the  chopped  meat,  without  any  water.,  into  a 
small  vessel,  w^hich  is  set  into  a  kettle  of  w^arm  water.  Heat  gradually, 
keeping  the  water  in  the  kettle  above  blood-heat,  but  do  not  allow  it  to 
boil.  Remove  the  small  vessel  containing  the  meat  and  the  juice  which 
has  exuded  from  it,  strain  its  contents,  season,  and  serve. 

As  thus  prepared,  beef-tea  is  somewhat  more  nutritious  than  Liebig's 
extract ;  still,  its  chief  value  is  to  those  who  need  a  stimulant,  and  to  those 
for  whom  a  very  small  amount  of  food  is  sufficient. 

Fluid  Meats  and  Peptones.  These  are  supposed  to  be  formed  by 
artificial  digestion,  whereby  the  same  products  are  produced  as  in  the 
stomach.  The  best  of  them  are  of  value  ;  others  are  worthless.  They 
are  to  be  regarded  as  medicines,  and  are  to  be  used  according  to  the 
directions  of  the  physician. 

Bone  a?zd  Cai'tilage.  Bone  consists  of  a  gelatine  forming  organic  sub- 
stance, and  of  mineral  salts.  Besides,  the  marrow  contains  considerable 
fat  and  a  little  albumen.  About  one  third  of  bone  is  organic  matter,  a 
large  part  of  which  is  soluble  in  boiling  water.  For  this  reason,  bone  is 
of  value  in  making  soups.  The  long  bones  are  not  acted  upon  by  water 
readily,  unless  they  first  be  cut  or  ground  into  small  pieces.  The  bones 
of  the  spine  and  the  ribs  make  a  very  nutritious  soup,  which  yields  as 
much  as  twenty-four  per  cent,  of  the  weight  of  the  bone  in  solid  matter. 
Bones  should  be  boiled  for  several  hours,  in  order  to  get  all  the  food- 
stuffs out  of  them.  When  we  remember  that  these  soups  are  also  used 
for  the  purpose  of  serving  vegetables,  we  may  appreciate  the  real  value 
of  bone  as  a  source  of  food. 

MILK.^ 

Milk  is  a  white,  yellowish  white,  or  bluish  white  fluid.  It  consists  of 
a  colorless  fluid  holding  milk  globules  in  suspension.  These  globules 
render  the  fluid  opaque. 

The  reaction  of  fresh  milk  (cows')  is  sometimes  alkaline,  sometimes 
acid  ;  but,  as  a  rule,  it  gives  both  reactions,  turning  blue  litmus  paper 
red  ;  and  red  litmus,  blue. 

Composition.  Milk  contains  representatives  of  all  the  classes  of  food. 
The  albuminous  constituents  are  casein  and  albumen.  The  former  is 
coagulated  when  the  milk  becomes  sour,  or  on  the  addition  of  an  acid,  or 
by  the  action  of  rennet.     The  albumen  is  precipitated  by  heat.     The 

^As  cow's  mOk  is  the  only  kind  that  is  used  as  a  commercial  food  in  this  country,  all  the  state- 
ments made  will  refer  to  this  kind  unless  some  other  kind  be  specified. 


42  HEALTHY  FOODS. 

amount  of  casein  is  much  larger  than  that  of  albumen.  There  is  also  a 
nitrogenous  constituent  which  is  not  coagulated  by  either  heat  or  acids. 

The  fat  of  milk  forms  butter,  and  the  importance  of  this  constituent  is 
so  great  that  we  often  decide  as  to  the  value  of  a  given  sample  of  milk 
from  the  amount  of  butter  which  it  yields. 

Milk  sugar  has  the  same  chemical  composition  as  cane  sugar  ;  but  they 
differ  somewhat  m  their  physical  properties. 

If  some  milk  be  evaporated  to  dryness  and  the  residue  be  burned,  there 
remains  a  flaky,  white  ash,  which  contains  all  the  inorganic  salts  which 
are  absolutely  necessary  to  the  body. 

The  following  table  gives  the  average  per  cent,  composition  of  milk : 

Water.  Casein  and  Albumen.  Fat,  Milk  Sugar.  Ash. 

87-5  3-5  3-5  4-8  0.7 

Colostrum.  The  fluid  which  the  cow  yields  directly  after  calving  is 
known  as  colostrum,  which  differs  essentially  in  composition  from  milk, 
and  is  unfit  for  human  food.  It  gradually,  however,  approximates  milk, 
and  the  change  may  be  regarded  as  complete  by  the  eighth  or  tenth 
day.  The  fat  of  colostrum  is  in  large  lumps,  and  it  contains  much  more 
albumen  than  milk  does.  Its  avei'age  composition  is  shown  by  the  follow- 
ing figures  : 

Water.  Albumen  and  Casein.  Fat.  Milk  Sugar.  Ash. 

73.07  19.21  3.54  3.00  1. 18 

The  Care  of  Milk.  Milk  should  not  be  allowed  to  stand  in  copper, 
brass,  or  zinc  vessels,  nor  in  earthen  vessels  which  are  lined  with  lead 
glazing ;  for  if  the  milk  should  become  at  all  sour,  traces  of  the  metal 
mav  be  dissolved  in  it.  There  is  no  objection  to  wooden  vessels  if  they 
are  kept  scrupulously  clean.  But  when  emptied  they  should  be  scalded 
with  boiling  water,  and  then  dried  before  they  are  refilled.  There  are 
also  no  objections  to  the  best  glazed  earthen  or  to  well  tinned  vessels. 

Milk  should  not  be  allowed  to  stand  uncovered  in  an  occupied  room, 
especially  in  a  sitting-  or  a  bed-room.  The  fluid  rapidly  absorbs  gases 
which  may  set  up  putrefactive  changes  in  it.  Besides,  the  dust  which 
falls  into  it  may  contain  disease  gei'ms,  and  these,  finding  a  suitable  jDlace 
for  their  development,  may  multiply  rapidly.  There  can  be  no  question 
that  milk  has  often  served  as  the  vehicle  for  distributing  the  germs  of  scar- 
let fever  and  diphtheria,  which  have  fallen  into  it,  or  have  been  introduced 
with  the  water  which  has  been  used  in  diluting  the  milk,  or  for  washing 
the  vessels  in  which  it  is  carried. 

Souring  of  Milk.  This  fluid,  on  standing,  sooner  or  later  becomes 
distinctly  sour,  and  its  casein  is  coagulated.  This  is  due  to  the  action 
of  a  ferment,  which  is  always  present  in  the  milk,  on  the  milk-sugar, 
which  is  converted  into  lactic  acid.  The  coagulated  casein  is  known  as 
"clabber,"'  and  the  fluid  portion  forms  whey.  The  best  method  of  re- 
tarding the  souring  process  in  milk  consists  in  kee^Ding  it  in  a  cool  place. 


HEALTHY  FOODS.  43 

Boiling  has  a  similar  effect,  but  it  alters  the  nature  of  the  fluid  more  or 
less.  Milkmen  sometimes  add  bicarbonate  of  soda  to  milk  to  prevent  its 
souring.     The  alkali  simply  neutralizes  the  acid  as  fast  as  it  is  formed. 

Adulterations.  While  a  great  deal  that  is  sensational  has  been  said 
about  the  adulterations  of  milk,  these  frauds  are  perpetrated  too  fre- 
quently. A  food  which  forms  the  principal,  and  in  many  instances  the 
sole,  sustenance  of  children,  should  be  kept  free  from  any  adulteration 
which  in  any  way  lessens  its  nutritive  value.  To  furnish  a  child  with 
watered  milk  is  often  to  slowly  starve  it  to  death,  and  the  person  guilty 
of  such  an  act  should  be  treated  as  a  criminal. 

The  adulterations  practised  in  the  sale  of  milk  are  as  follows  : 

(i)  The  addition  of  water,  (2)  the  removal  of  more  or  less  of  the 
cream,  (3)  the  addition  of  some  foreign  solid  substance  to  increase- the 
opacity  or  density  of  the  fluid. 

The  addition  of  water  is  the  fraud  most  commonly  practised.  The 
amount  added  varies  from  ten  to  fifty  per  cent,  of  the  milk  ;  though  the 
former  figure  is  probably  the  one  most  frequently  approximated.  Several 
states  have  laws  defining  the  amount  of  milk  solids,  which  must  be  pres- 
ent. Wherever  these  laws  are  enforced  they  form  a  valuable  protection 
to  the  consumer,  and  to  honest  dairymen  as  well.  Unfortunately,  there 
is  no  ready  test  capable  of  being  used  by  any  one,  by  which  the  exact 
amount  of  water  can  be  determined.  The  amount  of  cream  which 
forms  on  a  given  volume  of  milk  standing  in  a  tall  glass  tube  or  other 
vessel  is  a  rough  but  valuable  method  which  every  housewife  may  em- 
ploy. From  this  she  cannot  say  with  certainty  to  her  milkman  that  he 
has  watered  his  milk,  but  she  can  tell  him  that  the  milk  is  not  as  rich  as 
it  should  be. 

However,  it  must  be  remembered  that  the  cream  rises  on  milk  much 
quicker  under  some  conditions  than  under  others.  Watery  milk  may  be 
produced  by  feeding  cows  upon  sloppy  food,  such  as  the  refuse  from 
breweries,  as  well  as  by  the  direct  addition  of  water.  Besides,  watery 
milk  often  has  a  bluish  color,  and  is  not  as  opaque  as  healthy  milk ; 
though  this  appearance  is  sometimes  hidden  by  the  addition  of  a  yellow 
coloring  substance,  annatto. 

Skimmed  milk  is  frequently  sold  for  whole  milk.  In  certain  states 
there  are  very  excellent  laws  against  such  a  practice.  The  same  rough 
test  may  be  made  as  given  above  for  watered  milk.  Sometimes  skimmed 
milk  is  added  to  an  unskimmed  portion,  and  then  sold  as  whole  milk. 

The  addition  of  foreign  solids  is  not  frequently  resorted  to.  The  most 
common  substance  used  is  bicarbonate  of  soda  for  the  purpose  of  prevent- 
ing the  souring  of  the  milk,  as  has  already  been  stated.  In  the  amount 
used,  it  does  not  affect  the  food  value  of  the  milk.  It  is  frequently  said 
that  chalk,  gypsum,  and  gum  arable  are  added  to  milk.  They  may  be 
used  occasionally  ;  but  stupid  indeed  must  be  the  consumer  who  would 
not  detect  these  substances,  which,  on  account  of  their  insolubility,  would 
be  deposited  in  the  vessel.  It  has  also  been  stated  that  the  brains  of 
calves  and  other  animals  are  pulverized  or  ground  fine,  and  placed  in 


44  HEALTHY  FOODS. 

milk.  This  is  an  adulteration  found  in  sensational  books,  but  not  in 
milk. 

Diseased  Milk.  There  can  be  no  question  about  the  possibility  of  the 
transmission  of  certain  diseases  from  the  lower  animal  to  man  through 
the  use  of  milk  as  a  food.  In  inflammation  of  the  udder,  the  secretion  of 
the  gland  is  diminished,  and  the  act  of  milking  causes  the  animal  much 
pain.  The  milk  is  of  unpleasant  odor,  and  contains  lumps  of  coagulated 
casein  and  albumen,  and  sometimes  blood  and  jdus.  Such  milk  may 
cause  irritation  and  even  inflammation  of  the  stomach  in  children.  *  In 
all  acute  febrile  diseases  of  cows  the  amount  of  the  secretion  is  dimin- 
ished, and  in  severe  fevers  the  flow^  of  milk  ceases  altogether.  In  chronic 
diseases,  as  those  of  the  digestive  organs,  the  milk  becomes  thin  and 
watery. 

The  cause  of  the  disease  known  as  milk-sickness,  which  has  prevailed 
in  certain  parts  of  Illinois,  Indiana,  Kentucky,  Tennessee,  Geoi^gia,  and 
some  other  states,  has  never  been  ascertained.  Some  ascribe  it  to  plants 
which  the  cows  eat ;  others  are  equally  certain  that  the  drinking  water  is 
the  source.  As  the  country  becomes  more  improved,  the  disease  appears 
less  frequently.  This  would  lead  us  to  suppose  that  the  poison  is 
obtained  from  some  native  plant  which  is  destroyed  by  cultivation  of  the 
soil. 

Unfortunately,  in  many  diseases  of  cows,  during  the  first  stages  at 
least,  the  changes  in  the  character  of  the  milk  are  not  sufficiently  marked 
to  be  observed  ; — however,  the  following  kinds  of  milk  should  be  avoided  : 

(i)  Milk  which  becomes  sour  and  curdles  within  a  few  hours  after  it 
has  been  drawn,  and  before  any  cream  forms  on  its  surface.  This  is 
known  in  some  sections  as  "  curdly"  milk,  and  it  comes  from  cows  with 
certain  inflammatory  affections  of  the  udder,  or  with  digestive  diseases, 
or  from  those  w^hich  have  been  over-driven  or  worried. 

(2)  "Bitter-sweet  milk"  is  that  whose  cream  has  a  bitter  taste,  is  cov- 
ered w^ith  "blisters,"  and  frequently  with  a  fine  mold.  Butter  and  cheese 
made  from  such  milk  cannot  be  eaten  on  account  of  the  disagreeable 
taste. 

(3)  "  Slimy  milk"  can  be  drawn  out  into  fine  ropy  fibres.  It  has  ah 
unpleasant  taste,  which  is  most  marked  in  the  cream.  The  causes  which 
lead  to  the  secretion  of  this  milk  are  not  known. 

(4)  "Blue  milk"  is  characterized  by  the  appearance  on  its  surface, 
eighteen  or  twenty  hours  after  it  is  drawn,  of  small  indigo-blue  spots, 
w^hich  rapidly  enlarge  until  the  whole  surface  is  covered  with  a  blue  film. 
If  the  milk  be  allowed  to  stand  for  a  few  days,  the  blue  is  converted  into 
a  greenish  or  reddish  color.  This  coloration  of  the  milk  is  due  to  the 
growth  of  a  microscopic  organism.  The  butter  made  from  "  blue  milk" 
is  dirty-white  in  color,  gelatinous  in  consistency,  and  bitter  in  taste. 

(5)  "Barn-yard  milk"  is  a  term  used  to  designate  milk  taken  from 
unclean  animals,  or  those  which  have  ])een  kept  in  filthy,  unventilated 
stables.  The  milk  absorbs  and  carries  the  odors,  which  are  often  plainly 
perceptible.     Such  milk  may  not  be  poisonous,  but  it  is  repulsive. 


HEALTHY  FOODS.  45 

The  Value  of  Milk  as  a  Food.  The  importance  of  this  article  of  diet 
can  hardly  be  be  over-estimated.  For  childi*en,  it  is  the  mainstay.  For 
adults,  it  is  a  substance  palatable  and  easily  digested.  About  two  quarts 
of  good  rich  milk  per  day  will  support  life,  even  if  no  other  food  be  taken. 
One  sick  with  a  wasting  disease,  such  as  typhoid  fever,  has  his  chances 
of  recovery  greatly  increased  if  he  takes  milk  with  comfort  and  digests  it 
with  ease.  For  the  infant,  there  is  no  other  food  which  can  fully  sup- 
plant the  milk  of  the  mother.  Physicians  of  large  experience  say  that 
the  chances  of  rearing  a  babe  are  50  per  cent,  better  when  it  is  well  sup- 
plied with  healthy  milk  by  its  mother  than  when  nourished  by  artificial 
preparations.  Woman's  milk  contains  less  fat  and  casein,  and  more 
sugar,  than  the  cow's  milk.  When  it  becomes  absolutely  necessary  to 
substitute  the  latter  for  the  former,  the  cow's  milk  should  be  diluted  with 
one  third  its  volume  of  warm  water,  and  one  half  ounce  of  milk-sugar 
should  be  added  to  each  pint.  As  the  child  grows  older,  the  amount  of 
water  added  should  be  diminished,  until,  at  the  age  of  six  months,  imdi- 
luted  cows'  milk  may  be  used. 

Condensed  Milk.  This  is  prepared  by  evaporating  milk  in  a  vacuum 
to  one  fifth  its  volume,  or  to  the  consistency  of  honey,  placing  it  in  cans, 
which  are  set  in  water,  the  temperature  of  which  is  raised  to  the  boiling 
point,  when  the  cans  are  sealed.  Sometimes  cane  sugar  is  added  after 
evaporation.  When  used,  condensed  milk  is  diluted  with  five  times  its 
volume  of  warm  water.  It  forms  a  valuable  substitute  for  fresh  milk 
when  the  latter  cannot  be  obtained.  Its  exact  value  will  depend  upon 
the  quality  of  the  milk  used  in  its  preparation.  The  three  most  prom- 
inent brands  of  this  preparation  used  in  this  country  are  the  Anchor,  the 
Swiss,  and  the  Anglo-Swiss.  The  writer  has  examined  these,  and  found 
them  all  of  good  quality. 

BUTTER. 

Of  all  the  fats,  butter  is  the  most  palatable  and  most  easily  digested. 
Only  when  it  is  rancid  does  it  lead  to  dyspepsia.  It,  like  all  other  fats, 
should  be  taken  in  a  finely  divided  state.  Its  food  value  is  great,  and  the 
amount  consumed  per  head  daily  is  about  one  ounce. 

Physical  Properties.  Good  butter  is  of  a  pale  yellow  color,  which  is 
uniformly  diffused  through  it.  The  exact  color  of  butter  varies  with  the 
food  of  the  cow  ;  but  as  a  yellow  butter  is  universally  demanded  in  mar- 
ket, makers  almost  invariably  use  a  preparation  of  annatto.  This  arti- 
ficial coloration  has  been  so  long  practised,  and  as  the  use  of  the  coloring 
material  is  not  detrimental  to  health,  it  may  be  regarded  as  a  legitiinate 
use.  Good  butter  is  free  from  rancid  taste  and  odor.  White  lumps  in 
butter  are  due  to  the  coagulation  of  casein,  from  the  milk  becoming  too 
acid,  and  its  incorporation  with  the  cream.  When  a  watery  fluid  exudes 
from  the  freshly  cut  surface  of  butter,  it  is  evidence  that  the  buttermilk 
was  not  expressed  as  thoroughly  as  it  should  have  been,  or  that  water 
has  been  added  for  the  purpose  of  increasing  the  weight. 

Composition.     The  amount  of  water  in  butter  will  depend  upon  the 


46  HEALTHY  FOODS. 

• 

manner  of  preparation  and  the  quantity  of  salt  added.  In  some  families 
an  unsalte<:l  butter  is  used.  This  does  not  contain  more  than  from  3  to 
6  per  cent,  of  water.  But  as  a  rule  more  or  less  salt  is  added  in  making 
the  butter.  This  is  done  to  insure  the  preservation  of  the  fat,  and  most 
people  consider  such  an  addition  an  improvement  to  the  taste.  Good 
salted  butter  will  not  contain  more  than  from  10  to  15  per  cent,  of  water, 
while  the  poorer  grades  may  contain  as  much  as  28  per  cent.  This  large 
amount  is  taken  up  only  when  boiling  water  is  mixed  with  the  fat,  and 
then  the  whole  allowed  to  cool. 

The  salt  used  in  butter  should  be  finely  pulverized  and  thoroughly 
mixed  with  the  fat.  From  3  to  5  per  cent,  of  salt  is  all  that  is  needed  for 
preservation,  but  in  order  to  increase  the  weight,  from  10  to  15  per  cent, 
is  sometimes  added.  Good  butter  contains  from  %^  to  90  per  cent,  of 
fat,  and  any  which  contains  less  than  82  per  cent,  may  be  considered  as 
adulterated.  The  most  common  fraud  in  regard  to  the  fat  consists  in  the 
use  of  tallow  and  lard,  which  will  be  discussed  under  the  heads  of  oleo- 
margarine and  butterine. 

The  greatest  amount  of  casein  permissible  in  butter  is  2  per  cent.  If 
there  be  much  more  present,  the  butter  is  lumpy.  There  is  now  being 
sold  to  dairymen  a  recipe  by  which  it  is  guaranteed  that  a  given  volume 
of  milk  will  be  made  to  yield  25  per  cent,  more  of  butter.  The  process 
consists  in  the  coagulation  of  all  the  casein  in  the  milk,  and  its  incorpora- 
tion with  the  fat.  The  product  is  really  not  butter  at  all,  but  an  inferior 
soft  cheese.  An  excess  of  casein  in  butter  increases  its  liability  to  become 
rancid. 

How  to  Take  Care  of  Butter.  Butter,  like  milk,  takes  up  unpleas- 
ant odors  :  for  this  reason  it  should  not  be  allowed  to  stand  exposed  to 
the  air  of  occupied  rooms,  nor  in  other  places  that  may  become  foul. 
When  freely  exposed  to  air  butter  becomes  rancid :  it  should  be  tightly 
packed  and  covered.  Warmth  hastens  rancidity  :  it  should  be  kept  in  a 
cool  place. 

OLEOMARGARINE   AND    BUTTERINE. 

Oleo7nargarine.  This  substance  is  now  largely  manufactured  and 
sold  in  this  country,  generally  under  the  name  of  butter,  but  sometimes 
under  its  proper  name.  It  is  made  as  follows  :  The  best  beef  fat  is  cut 
from  the  carcass  while  it  is  still  warm.  All  bloody  portions,  and  those 
tainted  in  any  other  way,  are  rejected.  The  selected  fat  is  placed  in 
fresh  cold  water,  in  which  it  is  both  cooled  and  washed.  It  is  then 
ground  like  sausage.  Then  it  is  heated  from  160°  to  180°  Fahr.,  by 
which  the  oil  is  separated  from  the  membranes.  The  oil,  after  being 
salted,  is  cooled,  and  then  pressed.  Then  it  is  placed  in  milk,  a  prepa- 
ration of  annatto  added,  and  the  whole  churned,  when  it  is  worked  as 
butter.  The  temperature  at  which  the  oil  is  separated  from  the  mem- 
brane should  be  as  low  as  possible  ;  but  in  practice  it  varies  within  large 
limits.  Some  manufacturers  use  a  heat  of  only  120°,  while  others  allow 
the  temperature  to  run  up  to  200°  F.  The  oil  thus  prepared  is  known  to 
the  trade  as  "  butter  oil." 


HEALTHY  FOODS.  47 

Btitterine.  This  is  prepared  by  the  mixture  of  "butter  oil"  obtained 
from  beef  fat,  as  in  making  oleomargarine,  and  a  similar  oil  obtained 
from  hog  fat,  and  churning  with  milk.  The  oil  from  the  lard  is  sepa- 
rated at  a  temperature  not  exceeding  1 20°  F. 

A  great  deal  has  been  said  against  the  use  of  these  preparations  as 
foods.  Several  states  have  law^s  which  require  that  when  such  articles 
are  sold,  the  buyer  shall  receive  them  from  a  vessel  which  is  labelled 
with  the  word  Oleomargarine,  or  Butterine,  as  the  case  may  be,  in 
letters  one  inch  high,  and  the  portion  taken  by  the  buyer  shall  be  cov- 
ered with  a  paper  which  also  bears  the  true  name  of  the  fat.  This  law 
is  certainly  a  just  one,  as  every  article  of  food  should  be  sold  under  its 
proper  name  ;  and  the  price  of  good  butter  should  not  be  demanded  for 
these  imitations.  At  least  two  states, — New  York  and  Michigan, — have 
enactments  which  wholly  forbid  the  manufacture  and  sale  of  these  prep- 
arations. These  laws  are  both  unwise  and  unjust.  Oleomargarine  and 
butterine  are  valuable  food-stuffs.  They  are  not  equal  to  the  best  grades 
of  butter,  but  are  far  superior  to  the  poor,  partly  rancid  butter  which 
is  so  generally'  sold  in  the  large  cities.  As  has  been  seen  from  the 
methods  of  preparation  given  above,  only  the  very  best  pieces  of  fat 
can  be  used.  Any  fat  which  has  an  unpleasant  odor,  or  is  in  the  least 
degree  foul,  must  be  rejected,  for  there  is  no  method  known  for  remov- 
ing the  odor. 

One  of  the  greatest  dietary  needs  of  the  working-man  is  a  sufficient 
supply  of  an  inexpensive,  wholesome  fat.  This  will  be  largely  met  by 
these  artificial  butters. 

CHEESE. 

Cheese  is  of  considerable  nutritive  value,  one  pound  containing  as 
much  nitrogen  as  two  pounds  of  meat,  and  as  much  fat  as  three  pounds 
of  meat;  but,  as  a  rule,  cheese  is  difficult  of  digestion,  and  can  be  taken 
only  in  small  amount  at  a  time.  Moreover,  the  exact  composition  of 
cheese  is  quite  variable.  It  is  made  both  from  whole  and  skimmed 
milk,  and  at  present  some  is  made  from  skimmed  milk  to  which  oleo- 
margarine or  butterine  has  been  added.  The  dairyman  skims  his  milk, 
making  butter  from  the  cream  ;  then  to  the  skimmed  milk  he  adds  the 
fatty  preparation,  and  makes  cheese.  In  this  way  the  same  milk  is  made 
to  produce  both  butter  and  cheese.  It  is  a  popular  idea,  that  while  cheese 
itself  is  digested  with  difficulty,  a  small  amount  of  it  in  the  stomach  aids 
the  digestion  of  other  substances.  The  experiments  of  Dr.  Edward 
Smith  have  confirmed  this  belief.  As  digestion  is  partly  due  to  fermen- 
tation, and  since  cheese  contains  certain  ferments,  the  belief  is  not  irra- 
tional ;  but  when  taken  as  an  aid  to  digestion,  the  amount  should  be  very 
small,  not  more  than  from  one  half  to  one  ounce. 

True  cream  cheese  is  made  from  whole  milk,  to  which  cream  has  been 
added;  but  what  is  ordinarily  known  as  "cream  cheese"  is  that  made 
from  unskimmed  milk.  In  such  a  cheese,  the  proportional  amounts  of 
casein  and  fat  are  substantially  the  same  as  in  good  milk.     Skimmed 


48  HEALTHY  FOODS. 

milk  cheese  is  not  so  nutritious  and  not  so  easy  of  digestion  as  that  made 
from  whole  milk. 

Cheese  is  almost  universally  colored  with  annatto,  which,  as  it  has 
been  so  long  used  and  is  not  detrimental  to  health,  may  be  regarded  as  a 
justifiable  adulteration.  Without  it,  cheese  would  be  of  a  dingy- white 
color. 

EGGS. 

There  is  no  bird  whose  eggs  may  not  be  eaten  in  case  of  necessity. 
However,  the  eggs  of  flesh-eating  birds  are  of  strong,  unpleasant  odor. 
Practically,  our  use  of  eggs  as  food  is  confined  to  those  of  the  chicken, 
duck,  Guinea  hen,  and  goose.  The  exact  taste  of  eggs  is  influenced 
largely  by  the  food  of  the  bird.  The  nutritive  value  of  eggs  is  great,  both 
on  account  of  their  chemical  composition  and  their  flavor.  The  average 
weight  of  hens'  eggs  is  from  ij^  to  2  ounces,  the  parts  existing  in  the 
following  proportions : 

Shell, .         .         11.5  per  cent. 

Albumen  (white), 58.5       " 

Yolk, 30.0       " 

The  white  of  the  egg  consists  of  water  and  albumen,  with  traces  of 
inorganic  salts  and  fat.  The  yolk  contains  from  30  to  32  per  cent,  of 
fat ;  so  that,  practically  speaking,  the  fat  is  confined  to  the  yolk.  There 
is  not  much  difference  in  the  time  required  for  the  digestion  of  a  raw  egg 
and  one  which  has  its  albumen  coagulated  by  heat,  but  the  latter  is  the 
more  agreeable  in  flavor.  A  hard-boiled  e.^^  is  digested  with  more 
difficulty  than  one  rarely  done. 

Since  eggs  are  most  abundant  and  consequently  cheapest  during  spring 
and  summer,  their  preservation  is  of  considerable  importance.  When 
left  exposed  to  the  air,  germs  pass  through  the  shell  and  cause  decompo- 
sition. Consequently,  tlie  object  to  be  held  in  view  in  endeavoring  to 
preserve  them  is  to  exclude  the  air.  This  may  be  done  by  placing  them 
in  lime-water  ;  but  in  this  way  the  shells  are  made  very  brittle,  and  many 
are  broken  in  removing  them.  They  may  be  dipped  in  mucilage,  and 
then  packed  in  salt.  However,  the  most  common  method  consists  sim- 
ply in  packing  them  in  salt  alone,  or  in  salt  and  lime.  Some  dip  the 
eggs  for  a  moment  in  boiling  water,  whereby  the  part  of  the  white 
immediately  in  contact  with  the  shell  is  coagulated. 

Decomposed  eggs  will  float  in  brine  (made  by  dissolving  one  part  salt 
in  ten  parts  of  water) ,  while  fresh  eggs  placed  in  the  same  solution  will 
sink. 

VEGETABLE   FOODS. 

CEREALS  AND  GRAINS. 

The  cereals  used  as  food  in  this  country  are  wheat,  rye,  oats,  corn,, 
and  rice.    The  most  important  food  constituents  of  the  grains  are  starch,. 


HEALTHY  FOODS.  49 

proteids  or  nitrogenous  substances,  and  the  phosphates  of  the  ash.  They 
also  contain  small  amounts  of  fat,  sugar,  gum,  and  mineral  substances 
other  than  the  phosphates. 

Of  all  the  grains,  wheat  is  considered  the  most  nutritious.  Its  exact 
composition  varies  slightly,  according  to  climate,  nature  of  the  soil,  and 
the  fertilization  employed.  Its  average  per  cent,  composition  is  given  in 
the  following  figures : 


Water. 

Proteids. 

Fat. 

Sugar. 

Starch. 

Cellulose. 

Ash. 

13-56 

12.42 

1.70 

1.44 

64.07 

2.66 

1.79 

The  nitrogenous  substances  consist  of  vegetable  albumen,  casein,  and 
gluten.  The  last  mentioned  forms  by  far  the  greater  part  of  the  nitrog- 
enous material.  The  ash  may  contain  as  much  as  45  per  cent,  of  phos- 
phoric acid,  which  is  combined  with  lime,  magnesia,  and  potash.  As  a 
rule,  the  greater  the  amount  of  phosphoric  acid  in  the  ash  of  the  wheat, 
the  greater  the  amount  of  nitrogenous  matter  in  the  grain. 

Rye  does  not  differ  greatly  in  its  composition  from  wheat,  as  is  shown 
by  the  following  figures,  which  give  the  average  of  forty-four  analyses 
collected  by  Konig : 


Water. 

Proteids. 

Fat. 

Sugar. 

Gum, 

Starch. 

Cellulose. 

Ash. 

15.26 

11-43 

I.71 

0-95 

4.88 

61.99 

2.01 

1.77 

However,  the  gluten  of  wheat  is  superior  in  quality  to  that  of  rye.  In 
those  countries  whose  inhabitants  are  compelled  to  depend  largely  upon 
rye  bread,  there  is  much  suffering  at  times  from  poisoning  with  ergot. 
Fortunately,  this  poison  is  not  found  to  any  extent  in  wheat. 

Oat  meal,  which  has  been  used  as  a  food  in  Scotland  for  a  long  time, 
is  now  being  largely  consumed  in  the  United  States,  and  it  is  to  be  hoped 
that  its  use  will  become  more  universal.  It  is  a  highly  nutritious,  healthy, 
and  cheap  article  of  diet.  The  average  composition  of  the  grain  is  as  fol- 
lows: 


Water. 

Proteids. 

Fat. 

Sugar. 

Gum, 

Starch. 

Cellulose. 

Ash. 

12.37 

10.41 

5-23 

I.9I 

1.79 

54-08 

II. 19 

3.02 

It  will  be  noticed  that  the  amount  of  fat  is  much  larger  than  in  wheat 
or  rye.  In  the  best  specimens  of  the  grain  the  fat  may  be  as  much  as  8 
per  cent. 

Corn  is  largely  used  in  some  of  the  Southern  states,  and,  in  the  various 
ways  in  which  the  people  know  so  well  how  to  prepare  it,  it  forms  a 
most  valuable  food.  The  exact  composition  varies  considerably  with  the 
variety  of  the  plant  and  tiiesoil  on  which  it  grows  ;  but  the  following  are 
the  average  figures : 


Water. 

Proteids. 

Fat. 

Sugar. 

Gum. 

Starch. 

Cellulose. 

Ash. 

13.12 

9.85 

4.62 

2.46 

3-38 

62.57 

2-49 

I-5I 

The  greater  part  of  the  nitrogenous  material  consists  of  vegetable  fibrine. 
Rice  grains  have  the  following  average  composition  : 


50 

HE/. 

ILTHY  FOi 

IDS. 

Water. 

Proteids. 

Fat. 

Starch. 

Gum. 

Cellulose. 

Ash'. 

9-55 

5.87 

1. 84 

73.00 

2.85 

5.80 

1.09 

Since  the  per  cents,  of  both  proteids  and  fats  are  low,  it  must  be  re- 
garded as  the  least  nutritious  of  the  grains  here  mentioned.  However, 
its  ease  of  digestion  renders  it  valuable  to  the  sick  ;  and  the  fact  that  its 
heat-producing  power  is  not  so  great  as  the  other  grains,  adapts  it  to  the 
inhabitants  of  warm  countries. 

Barley,  which  is  so  largely  used  by  the  Scandinavians,  and  millet, 
which  is  a  staple  food  in  India  and  some  other  warm  countries,  are  so 
seldom  used  in  this  country  as  foods  that  an  extended  notice  of  them  is 
unnecessary. 

Buckwheat  does  not  belong  to  the  cereals,  but  to  a  wholly  different 
class.  However,  as  it  is  a  food  which  is  highly  prized  by  many,  it  de- 
serves mention.  The  plant  soon  reaches  maturity,  and  may  be  grown 
upon  poor,  sandy  soil,  as  well  as  upon  richer  ground.  The  average 
composition  is  shown  by  the  following  figures  : 


Water. 

Proteids. 

Fat. 

Gum. 

Starch. 

Cellulose. 

Ash. 

13.63 

10.19 

1.28 

2.85 

69.30 

I-5I 

2.24 

The  albuminous  substances  found  in  buckwheat  differ  materially  from 
those  present  in  the  cereals.  Its  food  value  is  not  so  great  as  that  of 
wheat,  rye,  or  oats. 

FLOUR   AND    MEAL. 

By  grinding,  the  grains  which  have  been  described  are  converted  into 
flour  or  meal.  By  this  process  the  food  material  is  better  fitted  for  cook- 
ing, and  is  to  some  extent  separated  from  the  indigestible  portions.  A 
few  simple  rules  will  be  given  by  which  good  flour  or  meal  may  be  dis- 
tinguished from  the  inferior  grades  : 

(i)  Good  wheat  flour  is  white,  with  only  a  faint  yellow  tint.  It  does 
not  contain  any  bluish,  grayish,  or  dark  specks.  It  feels  soft  and  dry 
to  the  finger,  and  when  some  is  pressed  in  the  closed  hand,  it  forms  a 
dry  lump,  which  breaks  down  readily  with  the  gentlest  pressure.  If  it 
fails  to  form  a  lump  when  pressed  in  the  hand,  it  contains  too  much 
bran,  or  some  mineral  adulteration  has  been  added.  When  the  finger  is 
introduced  vertically  into  good  flour,  the  depression  thus  made  remains  ; 
otherwise,  there  is  too  much  bran  present.  The  odor  is  fresh  and  pleas- 
ant, not  musty.  Neither  with  the  unaided  eye  nor  with  a  magnifying 
glass  will  any  living  bodies  be  found  in  good  flour. 

(2)  Rye  flour  has  a  grayish  tint,  and  a  characteristic  odor  and  taste. 
The  other  general  properties  are  identical  with  those  of  wheat  flour. 

(3)  The  color  of  corn  meal  varies  with  the  variety  of  corn  from  which 
it  is  prepared.  It  should  feel  perfectly  dry  and  powdery.  It  does  not 
"lump"  when  pressed  in  the  hand,  and  it  has  a  characteristic,  pleasant 
odor.  Corn  meal,  when  decomposition  has  begun,  has  a  rancid  odor, 
and  if  some  of  it  be  placed  upon  a  piece  of  moistened  blue  litmus  paper 
(which  can  be  obtained  atany  drug  store),  the  color  of  the  paper  will  be 


HEAL  THY  FO  ODS.  5 1 

changed  to  red.     Good  meal  has  no  effect  on  the  color  of  the  litmus 
paper. 

(4)  Oat  meal  should  be  dry,  and  free  from  any  disagreeable  odor. 

The  Care  of  Meal  and  Flour.  When  exposed  to  the  air,  flour  and 
meal  absorb  water,  and  this  greatly  increases  their  tendency  to  decom- 
pose. In  moist  flour  the  lower  forms  of  life  are  likely  to  develop.  Foi 
these  reasons  these  preparations  should  be  kept  in  well  closed  recep- 
tacles. 

Adulter atio?i.  Fortunately,  these  foods  are  very  rarely  adulterated  in 
this  country.  Since  wires  have  been  used  so  extensively  for  binding  in 
the  great  wheat  fields  of  the  North-west,  a  small  amount  of  iron  is  found 
in  flour,  as  an  accidental  adulteration.  It  is  frequently  stated  that  gyp- 
sum and  other  mineral  substances  are  added  to  flour,  but  the  writer  has 
examined  many  hundred  samples,  and  has  never  detected  such  an  adul- 
teration. It  has  also  been  stated  that  the  so-called  "patent  flour"  contains 
alum.  This  is  certainly  false.  One  of  the  writer's  students  examined 
twenty-three  samples  of  "  patent  flour"  obtained  at  different  places,  and 
failed  to  find  any  alum  present.  It  may  be  possible  that  in  some  instances 
the  cheaper  flours  or  meals  are  added  to  wheat  flour  ;  but  even  this  fraud, 
if  practised  at  all  in  this  country,  is  carried  on  to  a  very  limited  extent. 
The  great  abundance  and  low  price  of  wheat  would  tend  to  make  any 
adulteration  profitless. 

BREAD. 

The  cooking  of  his  food  is  one  of  the  earliest  evidences  of  man's  civil- 
ization, and  with  no  other  food  has  the  process  of  cooking  been  so  thor- 
oughly developed  as  with  the  products  obtained  from  the  edible  grains. 
The  essential  constituents  of  bread  are  flour,  water,  and  salt.  To  these 
have  been  added,  for  the  purpose  of  varying  and  improving  the  taste,  one 
or  more  of  the  following  substances :  Milk,  sugar,  eggs,  fats,  etherial 
oils,  and  fruits.  Civilized  man,  in  every  part  of  the  world,  employs 
some  means  of  raising  or  leavening  his  bread.  By  this  the  taste  is  im- 
proved, and  the  crumb,  being  divided  by  the  evolved  gas,  is  more  readily 
acted  upon  by  the  digestive  juices.  The  methods  of  raising  bread  are  as 
follows : 

(i)  By  the  Growth  of  Teast.  Yeast  consists  of  microscopic  vegeta- 
ble organisms,  which,  when  placed  in  a  suitable  medium,  grow  rapidly, 
producing  alcohol  and  carbonic  acid  gas.  The  evolved  gas,  in  attempt- 
ing to  rise,  becomes  entangled  in  the  meshes  of  the  dough,  distending  it 
and  making  it  light.  After  the  dough  has  risen  sufficiently,  it  is  placed 
in  a  hot  oven  to  bake.  The  heat  destroys  the  yeast  plant,  and  thus  pre- 
vents further  fermentation.  If  the  growth  of  the  yeast  be  allowed  to  con- 
tinue for  too  long  a  time,  acetic,  lactic,  and  butyric  acids  are  formed,  and 
such  dough  makes  "  sour  bread." 

(2)  By  Baking  Powders.  In  the  use  of  baking  powders,  the  car- 
bonic acid  gas,  necessary  to  render  the  dough  light,  is  generated  by 
chemical  means.     Baking  powders  consist  of  some  alkaline  carbonate. 


$2  HEALTHY  FOODS. 

as  sodium  bicarbonate,  and  some  acid  substance,  such  as  the  acid  tar- 
trate of  potash  (cream  of  tartar) ,  together  with  a  small  amount  of  starch 
to  keep  the  mixture  dry.  As  long  as  the  powder  is  perfectly  dry  no 
reaction  occurs,  but  when  it  is  dissolved  in  water  in  the  dough,  the  acid 
acts  upon  the  carbonate,  liberating  carbonic  acid,  which  has  the  same 
effect  in  raising  the  dough  as  when  it  is  produced  by  the  growth  of  the 
yeast  plant. 

In  baking  powders,  ammonium  carbonate  is  sometimes  used  instead 
of  sodium  bicarbonate  ;  and  the  acid  tartrate  may  be  replaced  by  the  acid 
phosphate  of  lime.  But  the  use  of  alum  in  baking  powders  is  an  adul' 
teration  which  is  injurious  to  health.  It  unites  with  the  phosphates  in 
the  bread,  rendering  them  insoluble,  and  preventing  their  digestion  and 
absorption.  In  this  way  alum,  when  present,  diminishes  the  nutritive 
value  of  bread. 

A  small  amount  of  starch  in  baking  powders  is  necessary  to  keep  them 
dry,  but  too  often  the  manufacturer  adds  as  much  starch  as  possible, 
and  this  should  be  considered  as  an  adulteration. 

(3)  By  Aeration.  In  some  large  bakeries  carbonic  acid  gas,  gener- 
ated by  the  action  of  some  acid  on  carbonate  of  lime,  is  forced  under  pres- 
sure into  the  dough,  thus  distending  the  mass  ;  or  the  dough  is  kneaded 
with  water  which  has  been  saturated  with  carbonic  acid  under  pressure. 
When  the  gas  is  washed  before  being  forced  into  the  dough  or  water,  this 
method  is  a  very  desirable  one.  But  the  cost  and  care  of  the  special 
apparatus  necessary  will  prevent  the  adoption  of  this  method  of  raising 
bread,  except  in  large  bakeries  and  hotels. 

General  Properties  of  Good  Bread.  The  general  statements  con- 
cerning bread  refer  to  that  made  from  wheat  flour.  Good  bread  has  a 
thick,  fragile  crust,  which  is  not  burnt,  and  which  forms  from  25  to  30 
per  cent,  of  the  weight  of  the  loaf.  The  crumb  is  white,  and  filled  with 
cavities,  the  partitions  between  which  are  easily  broken  down.  These 
cavities  should  be  distributed  through  every  part  of  the  crumb  ;  other- 
wise, the  bread  is  sodden  and  heavy,  and  decomposes  quickly.  The 
bread  should  be  of  a  pleasant  odor  and  taste.  If  the  bread  is  acid,  it  was 
probably  made  from  inferior  flour. 

Changes  on  Standing.  On  standing,  bread  gradually  loses  weight, 
by  the  evaporation  of  a  part  of  its  contained  water,  and  becomes  hard. 
The  amount  of  water  given  off  in  a  certain  time  will  depend  upon  the 
size  of  the  loaf  and  the  nature  and  extent  of  the  crust.  Bread  should  not 
lose  more  than  3  per  cent,  of  its  original  weight  after  four  days.  Stale 
bread  when  dipped  in  water  and  rebaked,  or  when  steamed,  becomes 
palatable,  but  never  completely  regains  the  properties  of  fresh  bread.  In 
stale  bread,  small  living  organisms  are  likely  to  develop.  Some  of  them 
are  poisonous.  The  white  and  orange-yellow  moulds  which  form  on  stale 
bread  are  due  to  a  poisonous  growth.  Sometimes  blood-red  spots  appear 
in  bread.     These  also  are  due  to  a  microscopic  growth. 

Adulterations  of  Bread.  Bread  is  not  adulterated  to  any  great  extent 
in  this  country.     The  baker's  loaf  is  usually  of  light  weight.     An  excess 


HEALTHY  FOODS.  53 

of  water  is  often  incorporated  with  the  dough.  This  makes  the  bread 
sodden  and  heavy,  and  increases  its  liability  to  decompose.  In  some  of 
the  larger  cities,  mashed  potato  has  been  found  worked  into  bread.  This 
lowers  the  nutritive  value  of  the  article  greatly.  Alum  is  sometimes 
added  directly  to  flour  or  dough,  and  is  sometimes  contained  in  the  bak- 
ing powder,  as  has  been  stated. 

The  Food  Value  of  Bread.  As  has  been  remarked,  the  most  impor- 
tant food  constituents  of  the  grains,  and  consequently  of  bread,  are  the 
proteids,  starches,  and  ash.  The  amount  of  nitrogenous  matter  is  too 
small  for  a  perfect  food,  and  for  this  reason  bread  is  often  taken  with 
some  other  food  richer  in  nitrogen,  such  as  meat.  Bread  is  also  defi- 
cient in  fat,  and  man  instinctively  takes  some  kind  of  fat,  such  as  butter 
or  bacon,  along  with  his  bread.  Notwithstanding  these  imperfections, 
bread  is  a  food  of  which  we  never  tire,  and  the  various  ways  in  which  it 
is  prepared  aid  in  sharpening  the  appetite.  Besides,  while  some  impor- 
tant food  substances  are  not  abundant  in  bread,  all  are  present  to  a  greater 
or  less  extent ;  and  with  the  addition  of  a  little  more  nitrogen  in  the  shape 
of  meat  and  fat,  as  butter  or  bacon,  a  perfect  diet  is  secured. 

PEASE   AND    BEANS. 


Pease  and  beans  belong  to  the  leguminous  seeds.  They  contain  more 
nitrogenous  matter  or  proteids  than  any  other  vegetable  food.  Not  only 
is  the  amount  of  proteid  greater  than  in  wheat  and  other  grains,  but  it  is 
different  in  its  properties.  That  of  the  grains  is  principally  gluten,  while 
that  of  pease  and  beans  belong  to  the  casein  group.  The  former  is  more 
easily  digested  than  the  latter,  pease  and  beans  often  causing  disturbances 
in  the  stomach  and  bowels.  The  average  composition  of  these  foods  is 
shown  by  the  following  figures  : 

PEASE. 


Water. 

Proteids. 

Fat.                     Starch. 

Cellulose. 

Ash. 

14.99 

24.04 

1. 61                   49.01 
BEANS. 

7.09 

3.36. 

Water. 

Proteids. 

Fat.                   Starch. 

Cellulose. 

Ash. 

14.76 

24.27 

I.61                  49.01 

7.09 

3.26 

There  is  great  difference  between  the  digestibility  in  these  substances 
in  the  green  and  in  the  dried  state.  Soft  green  pease  tax  the  stomach 
but  slightly.  Dried  pease  and  beans  must  be  boiled  slowly  and  for  a 
long  time ;  and  if  they  are  very  old,  they  should  be  soaked  for  several 
hours,  and  then  crushed  before  they  are  cooked.  Hard  water  is  to  be 
avoided  in  cooking  them,  as  the  lime  of  the  water  forms  an  insoluble 
compound  with  the  albuminous  constituents  of  the  seeds. 

Ground  pease  and  beans  are  used  to  some  extent  in  this  country.  They 
form  a  part  of  some  food  preparations,  such  as  pea-sausage  (erbswiirste 
of  the  Germans). 


54  HEALTHY  FOODS. 

Food  Value  of  Pease  and  Beans.  The  nutritive  value  of  the  seeds 
is  considerable,  but  on  account  of  the  tax  which  they  impose  upon  the 
digestive  organs,  they  cannot  be  taken  in  large  quantities.  The  deficiency 
of  flit  is  usually  supplied  by  serving  these  foods  with  bacon  or  other  fatty 
food. 

POTATOES. 

Potatoes  contain  only  about  25  per  cent,  of  solids,  four  and  five-tenths 
of  which  is  starch.  The  per  cent,  of  nitrogenous  matter  and  fat  is  small 
as  shown  by  the  following  figures,  which  give  the  average  per  cent,  com- 
position of  potatoes : 

Water.  Proceids.  Fat.  Starch.  Cellulose.  Ash. 

75-77^  1-79  o-i^  20.56  0.75  0.97 

Notwithstanding  its  comparatively  small  per  cent,  of  solids,  the  potato 
will  continue  to  be  one  of  the  most  valuable  foods.  Its  growth  is  not 
influenced  by  soil  and  climate  to  such  an  extent  as  that  of  the  cereals. 
The  yield  of  the  potato  per  acre  is  greater  than  that  of  any  other  vegeta- 
ble. It  is  preserved  with  ease  for  winter's  use,  and  the  raw  material  is 
fitted  for  the  table  with  but  little  trouble  and  expense.  It  can  be  served 
in  a  great  variety  of  ways,  and  with  other  foods.  Its  deficiency  in  nitrog- 
enous matter  and  fat  is  made  up  by  cooking  it  with  meat.  It  is  agreea- 
ble to  the  taste,  and  easy  of  digestion.  New  potatoes  are  said  to  be 
waxy,  and  not  so  easily  digested  as  old,  mealy  ones.  In  order  to  retain 
the  salts,  potatoes  should  be  cooked  with  their  skins  on.  If  boiled,  they 
should  at  once  be  placed  in  hot  water.  If  baked,  the  oven  must  be  mod- 
erately hot. 

Potatoes  should  be  of  fair  size,  firm,  and  free  from  mould.  The  sweet 
potato  is  similar  in  composition  to  the  ordinary  potato,  and  furnishes  an 
agreeable  substitute  :  but  it  is  more  expensive,  and  cannot  be  preserved 
so  easily 

OTHER   VEGETABLES. 

The  other  succulent  vegetables  which  are  used  as  foods  are  principally 
useful  on  account  of  furnishing  variety,  and  for  the  acid  salts  which  they 
contain,  and  whose  use  renders  other  foods  more  digestible,  and  prevents 
scurvy  and  kindi^ed  affections. 

The  beet  root  is  not  only  a  pleasant  food,  but  furnishes  as  much  as  10 
per  cent,  of  sugar,  for  which  it  is  now  largely  grown  ;  though  the  differ- 
ent varieties  of  the  root  vary  considerably  in  the  amount  of  sugar  which 
they  contain. 

Turnips,  carrots,  and  parsnips  contain  from  82  to  90  per  cent,  of  water, 
from  5  to  10  per  cent,  of  starch,  from  2  to  6  per  cent,  of  sugar,  about  i 
per  cent,  each  of  nitrogenous  matter  and  salts,  and  \  i^er  cent,  or  less  of 
fat. 

Cabbage,  turnip  tops,    spinach,  water-cresses,  dandelion,  and    other 

greens"  should  always  be  thoroughly  cooked.  The  amount  of  absorb- 
able food  which  they  contain  is  generally  less  than  5  per  cent. 


HEALTHY  FOODS.  55 

The  tomato,  either  raw  or  cooked,  furnishes  an  agreeable  sauce.  It  is 
also  used  for  making  soup  and  for  flavoring  meat  soups.  It  contains  over 
92  per  cent,  of  water,  less  than  2  per  cent,  of  starch,  and  about  2^  per 
cent,  of  sugar. 

Rhubarb  is  a  pleasant,  acid  vegetable,  which  is  especially  serviceable 
on  account  of  its  being  one  of  the  earliest  of  spring  plants. 

Pumpkins  and  squash  contain  from  i  to  5  per  cent,  of  starch,  about  i 
per  cent,  of  sugar,  and  less  than  i  per  cent,  each  of  nitrogenous  matter, 
fat,  and  ash. 

Thoroughly  ripe  melons  are  beneficial  in  season  on  account  of  their 
action  upon  the  kidneys.  They  should  never  be  eaten,  however,  unless 
they  are  thoroughly  ripe  and  of  good  quality. 

STARCHES. 

The  food  value  of  the  starches  is  small,  but  they  are  easy  of  digestion, 
and  are  serviceable  in  preparing  dishes  for  the  sick.  Besides,  when  mixed 
with  nitrogenous  and  fatty  substances,  they  are  largely  used  in  making 
puddings.  In  this  way,  stale  bread  and  other  remnants  from  the  table 
may  be  converted  into  palatable  dishes- 
Sago  and  arrow-root  are  obtained  from  various  palms.  The  former 
appears  in  small  granular  masses,  which,  when  dry,  are  so  hard  that  they 
can  scarcely  be  crushed  by  the  teeth  ;  but  they  readily  absorb  water,  and 
soften. 

Arrow-root,  when  pure,  is  found  in  perfectly  white  lumps,  which  may 
readily  be  crushed  between  the  fingers.  When  boiled  with  water  and 
constantly  stirred,  no  foam  should  form  on  the  surface.  The  presence  of 
a  foam  indicates  that  the  arrow-root  has  been  adulterated  with  flour. 

Tapioca,  obtained  from  various  tropical  plants,  and  corn  and  potato 
starches,  are  also  used  in  puddings. 

SUGARS. 

Sugar  is  a  name  now  given  to  a  class  of  substances  which  vary  among 
themselves  to  some  extent  both  in  physical  and  chemical  properties, 
though  ordinarily  the  term  "  sugar"  is  supposed  to  refer  to  that  obtained 
from  the  sugar-cane  and  sugar  beet.  Practically  there  are  now  in  the 
trade  three  kinds  of  sugar, — cane  sugar  (obtained  from  the  cane  and 
beet) ,  glucose  or  grape  sugar  (obtained  by  the  action  of  dilute  acids  on 
starch),  and  "mixed  sugars,"  or  "new-process  sugars"  (consisting  of 
cane  and  grape  sugar  mixed  in  various  proportions).  Cane  sugar  is 
here  referred  to,  unless  some  other  is  specifically  mentioned. 

Sugar  is  used  for  modifying  the  taste  of  other  foods,  and  for  the  manu- 
facture of  confectionery  and  syrups.  By  improving  the  taste,  sugar, 
when  added  in  proper  amounts,  aids  the  digestion  of  other  substances, 
and  furnishes  a  certain  amount  of  nutriment  in  itself. 

Good,,  crystalline,  white  sugar  contains  less  than  one  half  of  i  per 


$6  HEALTHY  FOODS. 

cent.  01  water,  and  not  more  than  this  amount  of  ash.  Yellow  sugar 
may  contain  as  much  as  2  per  cent,  of  water. 

Grape  sugar  may  contain  from  lo  to  25  per  cent,  of  water,  and  from 
one  half  to  2  per  cent,  of  ash. 

Much  has  been  said  about  the  adulteration  of  sugar  with  glucose.  That 
this  has  been  practised  to  a  considerable  extent  is  shown  by  numerous 
analyses.  Indeed,  "  mixed  sugars"  are  sold  by  wholesale  dealers,  and 
too  frequently  the  retail  grocery-man  sells  these  to  his  customers  as 
straight  cane  sugars. 

Experts  can  recognize  these  sugars  by  the  way  they  "  handle."  "  They 
are  apt  to  cake  and  harden,  and  stick  to  the  scoop  and  sides  of  the  barrel. 
In  the  white,  granulated  sugars,  the  mixture  of  the  white  lumps  of  glu- 
cose with  the  crystalline  cane  sugar  can  be  readily  seen  ;  but  in  the  brown 
sugars  it  is  difficult  to  detect  the  fraud  by  the  appearance  of  the  sugar. 
When  a  mixed  sugar  is  shaken  with  cold  water,  the  white  lumps  of  the 
glucose  will  remain  undissolved  for  some  time  after  all  the  cane-sugar  has 
passed  into  solution." 

Glucose,  when  made  with  care, — and  it  must  be  so  made  when  it  is  used 
to  adulterate  sugar, — is  not  harmful  to  health.  The  fraud  is  a  pecuniary 
one,  as  glucose  costs  usually  less  than  two  cents  per  pound ;  but  when 
mixed  with  sugar,  it  is  sold  for  six  cents  and  more  per  pound.  The 
sweetening  properties  of  glucose  are  not  so  great  as  those  of  cane  sugar, 
and  consequently,  in  the  preparation  of  foods,  much  more  of  the  mixed 
sugar  is  required  than  would  be  necessary  with  cane  sugar. 

Confectionery.  The  various  candies  are  made  from  sugar,  or  sugar 
and  starch,  with  or  without  coloring  matters.  Twenty-seven  samples 
were  examined  under  the  writer's  direction,  in  order  to  ascertain  whether 
or  not  they  contained  any  poisonous  substance.  One  sample  consisted 
wholly  of  starch,  terra  alba,  and  an  analine  color,  without  any  sugar. 
The  use  of  terra  alba  (white  earth,  or  clay)  in  any  considerable  amount 
would  be  harmful  on  account  of  its  indigestibility.  Only  two  samples 
contained  ultra  marine  as  a  coloring  agent.  This  would  also  be  harmful 
if  used  in  large  quantity.  The  other  samples  were  all  free  from  any  sus- 
picious ingredient.  The  coloring  agent  most  frequently  used  is  analine. 
Grape  sugar  is  extensively  employed  in  the  manufacture  of  confectionery. 

Honey.  This  is  frequently  adulterated  with  glucose,  which  may  be 
added  directly  to  strained  honey,  or  may  be  fed  to  the  bees,  and  by  them 
deposited  in  the  comb.  Unadulterated  honey  varies  in  flavor  according 
to  the  jDlant  from  which  it  is  gathered.  White  clover  and  buckwheat 
honeys  are  much  prized  in  this  country.  The  fact  that  honey  sometimes 
produces  unpleasant  symptoms  is  probably  due  to  bees  feeding  upon 
poisonous  flowers,  though  the  susceptibility  of  the  individual  partaking 
of  it  probably  plays  an  important  part.  Pollen  grains  are  often  mixed 
with  honey,  and  the  unpleasant  effects  upon  the  system  may  be,  in  part 
at  least,  due  to  these. 

Molasses  and  Syrups.  These  are  solutions  of  sugar,  and  they  are  now 
frequently  made  by  a  mixture  of  cane  syrup  and  glucose.     Indeed,  many 


HEALTHY  FOODS.  57 

prefer  a  syrup  containing  glucose  :  it  is  not  so  sweet  as  a  pure  cane-sugar 
molasses.  However,  the  former  should  be  much  cheaper  than  the  latter. 
As  in  the  case  of  sugar,  the  fraud  here  practised  is  a  pecuniary  one  rather 
than  one  detrimental  to  health. 

FRUITS. 

Fruits  abound  in  tropical  and  temperate  climates,  and  furnish  a  great 
variety  of  flavors,  which  are  useful  in  themselves  and  for  the  purpose  of 
rendering  other  foods  more  enjoyable.  The  real  food  value  of  fruits, 
fudged  by  their  chemical  composition,  is  small,  but  when  thoroughly 
ripe  and  well  preserved,  they  act  beneficially  upon  the  system,  improv- 
ing the  appetite,  and  maintaining  a  healthy  condition  of  the  various  vital 
organs.  Probably  no  fruit  is  necessary  to  life,  and  fruits  may  be  regarded 
as  luxuries  ;  but  man's  instinct  and  cravings  prompt  him  to  obtain  them 
often,  even  when  their  cost  is  considerable.  Undoubtedly  they  are  most 
highly  prized  by  the  inhabitants  of  warm  countries,  where  foods  which 
produce  but  little  heat  are  most  desirable.  The  most  enjoyable  part  of 
fruits  is  their  juice,  which  consists  principally  of  watery  solutions  of 
sugar  and  acids.  The  amount  of  sugar  in  fruits  varies  from  i  to  i8  per 
cent.  The  cellular  parts  are  not  easily  digested ;  and  those  fruits  are 
prized  most  highly  which  have  the  greatest  quantity  of  juice  with  the 
smallest  proportion  of  cell  structure. 

The  majority  of  fruits  may  be  eaten  either  raw  or  cooked,  and  those 
which  cannot  be  preserved  in  their  natural  condition  may  be  dried. 
Therefore,  in  one  or  the  other  form,  they  may  be  enjoyed  at  any  season 
of  the  year,  and  may  be  served  with  other  foods. 

The  volatile  ethers,  upon  which  the  flavor  of  many  fruits  depends,  have 
been  made  artificially  by  the  chemist,  and,  under  the  name  of  essences, 
are  largely  used  in  cooking. 

It  is  wholly  unnecessary  even  to  mention  the  various  fruits  in  use,  as 
all  are  sufficiently  acquainted  with  their  general  properties  and  composi- 
tion. Suffice  it  to  say,  that  thoroughly  ripe  fruit,  taken  in  moderation, 
can  have  no  deleterious  effect  upon  the  system.  However,  care  should 
be  exercised  in  using  fruits  imported  from  countries  in  which  an  infec- 
tious disease,  such  as  cholera,  prevails.  Such  fruit  should  at  least  be 
thoroughly  washed,  or  stripped  of  its  covering,  and,  if  suitable  for  such 
purpose,  should  be  cooked. 

Canned  Fruits.  In  buying  canned  fruits,  it  should  be  observed  that 
the  ends  of  the  cans  are  concave.  If  convex,  there  has  probably  been 
some  decomposition  of  the  contents  with  the  evolution  of  gas.  Cases  of 
severe  poisoning  have  followed  the  eating  of  partially  decomposed  canned 
fruits.  Moreover,  if  the  cans  appear  old  and  battered,  thus  giving  evi- 
dence of  having  been  used  twice  or  oftener  for  the  purpose  of  preserving 
fruit,  they  should  be  rejected,  since  the  contents  of  such  cans  are  liable  to 
contain  small  amounts  of  tin  or  other  metal,  which  may  prove  poisonous. 
Much  having  been  said  about  the  use  of  salicylic  acid,  in  canned  fruits, 


58  HEALTHY  FOODS. 

as  a  preservative  agent,  the  writer  requested  one  of  his  students  to  examine 
samples  from  all  the  more  prominent  firms  engaged  in  the  preparation  of 
canned  foods,  for  this  adulteration.  In  no  case  was  the  acid  found.  Fre- 
quently agents  pass  through  the  country,  offering  to  sell  preparations  or 
recipes  for  the  sure  preservation  of  fruit.  The  active  ingredient  of  all 
tliese  formulas  is  salicylic  acid  or  some  form  of  sulphurous  acid.  The 
use  of  such  preservatives  is  unnecessary.  Moreover,  they  injure  the  taste 
of  the  fruit,  and  are  liable  to  prove  deleterious  to  the  health  of  the  con- 
sumer. 

Prof.  Sharpless  states  that  "  apple-sauce"  is  frequently  pumpkin  boiled 
with  cider  ;  that  the  raspberry-jam  offered  for  sale  is  often  sour  ;  and  that 
strawberry-jam  is  frequently  made  from  the  refuse  strawberries  of  the 
market. 

NUTS. 

Judging  solely  by  chemical  composition,  nuts  should  be  classed  among 
the  most  nutritious  foods.  The  following  figures  give  the  percentage 
composition  of  sweet  almonds,  walnuts,  and  hazelnuts,  from  numerous 
analyses  collected  by  Konig : 

Starch  and 
Water.         Proteids.  Fat.  Sugar.        Cellulose.  Ash. 

Almonds, 5.39  24.18  53.68  7.23  6.56  2.96 

Walnuts, 4.68  16.37  62.86  7.89  6.17  2.03 

Hazelnuts, 3.77  15-62  66.47  9-03  3-28  1.83 

But  nuts  are  not  easily  digested,  and,  with  the  exception  of  cocoa-nuts, 
do  not  form  an  important  part  of  the  food  of  any  people.  They  may  be 
regarded  simply  as  luxuries,  so  far  as  their  use  in  this  country  is  con- 
cerned. Crushed  acorns  are  used  to  some  extent  in  the  adulteration  of 
ground  coffee. 

VEGETABLE  OILS. 

On  account  of  our  abundant  supply  of  animal  fats,  the  vegetable  oils 
are  not  extensively  used  as  foods  in  this  country.  The  one  best  known  is 
olive  oil,  which  is  used  as  a  dressing  for  other  foods.  Olive  oil,  how- 
ever, has  been  largely  adulterated,  or  supplanted,  by  cotton-seed  oil, 
large  quantities  of  which  are  sold  as  olive  oil. 

CONDIMENTS. 

Condiments  are  substances  whose  employment  in  cooking  is  for  the 
sole  purpose  of  seasoning  foods.  However,  at  least  one  member  of  this 
class, — common  salt, — is  essential  to  healthy  existence.  Condiments  im- 
prove the  taste  of  foods,  sharpen  the  appetite,  and  improve  digestion. 
While  much  benefit  arises  from  this  use  in  small  amounts,  when  taken  in 
excess  they  may  prove  highly  detrimental  to  health. 

It  is  stated  that  certain  tribes  in  the  interior  of  Africa  exchange  gold 
for  salt,  ounce  for  ounce.  This  illustrates  the  great  need  of  this  sub- 
stance felt  by  the  animal  system.     We  know  that  wild  animals  some- 


HEALTHY  FOODS.  59 

times  travel  hundreds  of  miles  in  search  of  salt-licks.  Experiments  have 
been  made,  in  which  two  oxen  were  placed  under  exactly  the  same  con- 
ditions, and  furnished  with  the  same  food,  save  that  salt  was  denied  one, 
and  given  to  the  other.  The  one  deprived  of  salt  did  not  thrive  as  did 
the  other. 

The  purity  of  salt  is  judged  of  by  its  whiteness,  fineness,  dryness,  and 
perfect  solubility  in  water.  The  coarser  kinds  of  salt  contain  compounds 
of  lime  and  magnesium,  are  often  dark  in  color,  and  absorb  moisture 
from  the  atmosphere. 

Vinegar  is  an  acid  fluid,  which  may  be  produced  by  the  fermentation 
of  any  solution  containing  sugar.  Cider  and  wine  vinegars  are  most 
highly  prized,  though  the  following  varieties  are  now  sold  in  this  country : 

(i)   Cider  vinegar,  from  apples  and  pears. 

(2)  Wine  vinegar,  from  grape  juice  and  inferior  wines. 

(3)  Malt  vinegar,  from  barley. 

(4)  Beer  vinegar,  from  sour  ale  or  beer. 

(5)  Glucose  vinegar,  from  grape  sugar. 

(6)  Crab  vinegar,  from  crab-apples. 

(7)  Artificial  vinegar,  made  with  dilute  solutions  of  the  mineral  acids, 
especially  sulphuric  acid. 

The  acidity  of  vinegar  is  nominally  due  to  acetic  acid.  Sulphuric  acid 
is  sometimes  added  to  increase  the  acidity.  The  British  law  allows  this 
adulteration  to  the  extent  of  one  tenth  of  one  per  cent.  ;  but  if  the  vinegar 
be  properly  prepared,  such  an  addition  is  not  necessary  ;  and  if  any 
addition  be  allowed,  the  amount  is  likely  to  exceed  that  given  above. 
Burnt  sugar  is  sometimes  added  to  vinegar  to  give  it  color. 

The  per  cent,  of  acetic  acid  should  be  at  least  3.  Of  five  samples 
recently  examined,  the  smallest  per  cent,  was  3.2,  and  the  greatest,  6.7. 
Only  minute  traces  of  mineral  acids  were  found  in  three  of  these  sam- 
ples, while  the  other  two  were  wholly  free  from  such  adulteration. 

Table  mustards  are  frequently  diluted  with  tumeric,  flour,  or  yellow 
lakes.  Pepper  is  sometimes  mixed  with  flour,  bread,  or  starch.  Spices 
are  frequently  adulterated  with  flour,  starch,  bread,  and  ground  pea-nut 
shells.  Cloves  may  contain  arrow-root.  In  order  to  obtain  spices  pure, 
they  should  be  purchased  unground. 

TEA. 

Tea  is  the  most  extensively  used  and  the  least  harmful  of  all  beverages. 
Upon  most  persons  it  produces  agreeable  sensations;  "it  cheers,  but 
does  not  inebriate."  It  relieves,  to  a  certain  extent  at  least,  the  feeling 
of  bodily  weariness,  quickens  the  pulse,  and  deepens  the  respiration. 
Upon  the  nervous  system  it  acts  as  a  stimulant,  and  the  excitation  is  not, 
as  in  the  case  of  alcoholic  drinks,  followed  by  depression.  Considerable 
discussion  has  been  carried  on  over  the  question  whether  or  not  its  use 
increases  waste  of  tissue.  This  may  now  be  considered  as  settled  in  the 
affirmative.     Dr.  E.  Smith  and  others  have  repeatedly  shown  that  the 


60  HEALTHY  FOODS. 

amount  of  waste  matter  in  the  air  exhaled  from  the  kings  is  markedly 
increased.  Tea,  then,  acts  as  a  food  principally  by  hastening  the  oxida- 
tion or  burning  of  other  substances  in  the  body. 

It  creates  a  blast  which  burns  up  the  half  charred  debris  of  the  system, 
and  from  the  burning  or  oxidation  we  receive  increased  energy.  From 
what  has  been  said,  it  will  be  evident  that  the  only  time  when  tea  should 
be  used  is  late  in  the  day,  after  the  heaviest  meals  have  been  taken.  For 
the  weak  and  debilitated  it  is  not  suitable,  or  should  be  used  very  spar- 
ingly.    Its  tendency  to  produce  sleeplessness  may  also  restrict  its  use. 

So  far  as  its  chemical  composition  is  concerned,  tea  contains  but  little 
of  nutritive  value.  The  high  place  of  tea  among  foods  is  solely  due  to  its 
effect  upon  the  nervous  system. 

In  the  market  there  are  two  kinds  of  tea, — green  and  black.  Until 
recently  it  was  supposed  that  these  were  products  of  different  species,  or 
at  least  of  varieties,  of  the  tea  plant ;  but  it  is  now  known  that  the  two 
kinds  arise  from  different  methods  of  curing  the  leaves.  In  preparing 
green  tea,  the  leaves  are  dried  immediately  ;  while  in  the  other,  the  leaves 
are  thrown,  into  heaps,  and  a  certain  degree  of  fermentation  or  decompo- 
sition is  allowed  to  take  place  before  the  drying  is  perfected. 

The  chief  constituents  of  tea  ai'e  its  active  principle  called  theine,  which 
is  identical  with  the  active  principle  of  coffee,  a  volatile  oil,  tannic  acid, 
and  a  small  amount  of  ordinary  food  substances. 

Theine  forms  from  2  to  3  per  cent,  of  tea.  In  making  tea,  as  is  ordina- 
rily done,  the  greater  part  of  the  theine  is  dissolved  out  of  the  leaves, — 
tea  yielding  its  active  principle  to  water  more  readily  than  coffee.  From 
equal  weights,  three  times  as  much  theine  is  obtained  from  tea  as  from 
coffee.  According  to  the  investigations  of  Mr.  Fellows,  224  five-ounce 
cups  of  tea  beverage  are  made  from  one  pound  of  tea,  and  45  eight-ounce 
cups  from  a  pound  of  coffee.  This  makes  the  cost  of  an  ordinary  cup  of 
tea,  when  the  leaf  sells  at  75  cents  per  pound,  about  one  third  of  a  cent ; 
and  of  a  cup  of  coffee,  when  the  berry  sells  at  27  cents  per  pound,  about 
three  fifths  of  a  cent.  In  this  estimation  the  sugar  and  milk  added  to 
these  beverages  are  not  considered. 

The  volatile  oil  of  tea  is  the  special  stimulant,  and  the  market  value  of 
a  tea  depends  more  upon  this  than  any  other  constituent.  The  amount 
and  quality  of  this  substance  present  are  judged  by  the  odor  as  well  as  by 
the  taste  of  the  hot  beverage.  Large  tea  houses  have  experts  who  are 
called  "  tea-tasters,"  and  whose  duties  consist  of  deciding  as  to  the  value 
of  different  samples  by  the  odor  and  taste.  By  virtue  of  the  volatile  oil, 
tea  increases  the  flow  of  perspiration,  and  thus,  although  taken  hot,  may 
act  as  a  cooling  agent.  The  volatile  oil  is  more  abundant  in  green  than 
in  black  tea. 

Tannin  is  also  more  abundant  in  green  than  in  black  tea.  The  object 
in  making  tea  should  be  to  dissolve  as  little  of  the  tannin  as  possible,  and 
at  the  same  time  extract  as  much  as  possible  of  the  theine  and  volatile  oil. 
To  accomplish  this,  tea  should  be  steeped  five  or  ten  minutes,  by  no 
means  longer  than  ten  minutes  ;  but  the  water  should  be  kept  warm  after 


HEALTHY  FOODS.  6l 

that  until  the  beverage  is  drawn  for  drinking.  Mr.  Fellows  found  the 
amount  of  tannin  extracted  from  the  best  Japan  tea,  after  steeping  for 
five  minutes,  to  be  o.io  per  cent.  ;  after  ten  minutes,  0.98  per  cent.  ; 
after  thirty  minutes,  3.09  per  cent.  It  is  to  the  tannin  that  the  astringent 
properties  of  tea  are  due,  and  when  tea  has  been  boiled,  it  is  so  astrin- 
gent that  it  is  well-nigh  unfit  for  use,  and  indeed  may  cause  derangements 
of  the  digestive  organs. 

Tea  contains  small  amounts  of  albuminous  and  starchy  substances,  but, 
as  has  been  stated,  these  are  present  in  such  small  amounts  that  they  are 
not  worthy  of  consideration. 

Tea  is  subject  to  the  following  adulterations,  which,  fortunately,  are 
not  largely  used  at  present : 

(i)  "  Spent"  leaves,  those  which  have  been  once  used  for  making  tea, 
are  dried,  and  mixed  with  fresh  leaves.  This  adulteration  is  not  practised 
extensively  in  this  country. 

(2)  The  poorer  varieties  are  mixed  with  the  better,  and  the  whole  sold 
as  of  first  quality. 

(3)  Green  tea  is  sometime  tinted  with  indigo  and  gypsum  Prussian 
blue  is  said  also  to  be  used,  but  the  writer  has  failed  to  detect  it  after  ex- 
amining many  samples.  Black  tea  is  also  tinted  with  graphite.  This  is 
not  used  in  large  amounts,  and,  as  used,  is  not  detrimental  to  health,  but 
is  a  pecuniary  fraud. 

(4)  Other  leaves,  notably  those  of  the  willow,  elder,  and  beech,  are 
added  to  the  tea  leaves.  None  of  these  are  exactly  like  the  tea  leaf,  and 
the  adulteration  may  be  detected  by  close  inspection,  even  without  a 
microscope.  The  border  of  the  tea  leaf  is  serrated  nearly,  but  not  quite, 
to  the  stalk.  The  primary  veins  run  from  the  midrib  nearly  to  the  bor- 
der, and  turn  in  so  that  there  is  a  distinct  space  left  between  their  termi- 
nations and  the  border. 

Tea  dust,  which  consists  of  broken  leaves  and  sweepings  of  tea  storage 
houses,  is  a  legitimate  article  of  commerce,  yielding  an  average  of  1.27 
per  cent,  of  theine. 

COFFEE. 

It  is  unnecessary  to  go  into  detail  concerning  coffee,  since  it  resembles 
tea  in  so  many  of  its  properties.  The  active  principle  of  coffee,  called 
caffeine,  is  identical  in  chemical  composition  and  physiological  effects  with 
theine  of  tea.  The  per  cent,  of  this  substance  in  the  raw  coffee  berry  is 
about  one,  and  this  is  not  given  up  so  readily  to  water  as  that  in  tea. 

There  is  no  volatile  oil,  corresponding  to  that  of  tea,  in  raw  coffee  ;  but 
one  or  more  such  oils  are  generated  by  roasting.  The  physiological  action 
is  not  the  same,  however,  as  that  of  tea.  It  is  not  so  stimulating,  nor 
does  it  increase  the  perspiration  to  so  great  an  extent. 

Tannin  is  present  in  a  much  smaller  amount  than  in  tea,  and  for  this 
reason  the  steeping  of  coffee  may  be  carried  on  longer  than  ten  minutes. 

The  ungi-ound  coffee  cannot  be  adulterated  to  any  extent ;  but  the 
ground  coffee  put  in  packages  and  boxes  is  almost  universally  adulterated. 


62  HEALTHY  FOODS. 

Often  It  contains  no  coffee  at  all.  A  student  of  the  writer  examined  all 
the  specimens  that  could  be  obtained  in  the  market.  The  first,  known 
as  Java  coffee,  put  up  by  the  "  Centennial  Coffee  Company,"  of  New 
York,  contained,  besides  some  coffee,  chickory,  pease,  wheat,  acorns, 
and  corn.  The  second,  "Gillies  Gold  Medal  Java,"  contained  very  little 
coffee,  being  composed  principally  of  wheat,  much  of  it  unground  chick- 
ory, corn,  and  pease.  The  remaining  samples  were  ground  coffee,  sold 
in  bulk,  and  in  every  case  adulterated. 

CHOCOLATE. 

Chocolate  is  prepared  from  the  ground  seeds  of  the  fruit  of  the  cocoa 
palm.  Cocoa  nibs  consist  of  these  seeds,  which  are  about  the  size  oi 
almonds,  roughly  broken,  while  chocolate  contains  a  substance, — theo- 
bromine,— very  similar,  but  not  identical  with  theine  or  caffeine  ;  its  other 
constituents  give  it  a  very  different  position  in  the  class  of  foods.  The 
cocoa  seeds  contain  from  45  to  49  per  cent,  of  fat,  and  from  14  to  18  per 
cent,  of  nitrogenous  matter.  It  will  be  seen  from  this  that  these  seeds 
may  be  classed  among  the  most  nutritious  foods.  Chocolate  always  con- 
tains sugar,  which  has  been  mixed  with  the  ground  seeds. 

Chocolate  does  not  stimulate  the  nervous  system  to  anything  like  the 
extent  that  tea  and  coffee  do  ;  but  for  travellers  and  others  who  cannot 
obtain  milk,  chocolate  may  be  used  instead  of  that,  the  most  nutritious  of 
liquid  food. 

Chocolate  is  often  adulterated  by  the  addition  of  too  much  sugar,  or 
with  starch. 


THE  SANITARY  CONDITIONS  AND  NECESSITIES  OF 
SCHOOL-HOUSES  AND  SCHOOL-LIFE. 


By  D.  F.  LINCOLN,  M.  D., 
Boston,  Mass, 


DA  VENIAM  PUERIS. 


Copyright,  1886, 
By  Irving  A.  Watson,  Sec.  American   Public  Health  Association. 


All    Rights    Reserved, 


SCHOOL  HYGIENE. 


INTRODUCTORY. 


Two  men  should  be  mentioned  at  the  head  of  an  essay  of  this  sort,  as 
deserving  to  represent  the  beginning  of  the  ^'  movement "  in  school 
hygiene.  They  are  Cohn  of  Breslau,  w^hose  examinations  of  the  eyes  of 
school-children  made  a  very  powerful  impression  on  the  public  mind 
some  sixteen  years  ago,  and  Virchow,  whose  official  report  to  the  Prus- 
sian minister  of  education  (published  in  1869),  is  the  most  prominent 
document  that  can  be  referred  to  as  leading  the  way  in  reform. 

It  is  not  intended  in  this  essay  to  quote  largely  from  German  authori- 
ties. The  mere  statement  of  principles  and  facts  must  suffice  in  so  wide 
and  manifold  a  subject  as  the  present. 

It  should  be  noted  that  Virchow  makes  use  of  the  expression  "school- 
diseases."  He  is  probably  entitled  to  the  credit  of  inventing  the  word.  In 
the  list  which  he  gives  there  is  one  affection  which  we  need  not  dwell 
upon,  namely,  nose-bleed.  In  regard  to  another, — tubercular  consump- 
tion,— there  is  perhaps  a  deficiency  of  evidence  as  to  its  causation  in 
schools  in  America,  though  there  can  be  no  reasonable  doubt  that  it  is 
so  caused,  and  the  writer  has  the  highest  American  authority  for  saying  so. 

Deformity  of  the  spine  (lateral  curvature)  is  probably  not  so  common 
by  a  good  deal  in  America  as  Guillaume  represents  it  in  Switzerland. 
We  lack  decided  evidence  ;  but  it  is  spoken  of  under  the  proper  heads  in 
this  essay. 

It  remains  to  note  the  division  of  the  subject  which  has  been  followed, 
viz.  : 

1.  Site  of  the  School-House. 

2.  Plan  and  Arrangement  of  the  Building. 

3.  Ventilation  and  Heating, 

4.  Sewerage. 

5.  Hygiene  of  the  Eye. 

6.  School-Desks  and  Gymnastics. 

7.  Affections  of  the  Nervous  System. 

8.  Contagious  Disease. 

9.  Sanitary  Supervision. 

I.    SITE. 

In  choosing  the  site  for  a  school-building,  we  should  take  into  account 
a  number  of  things  which  might  be  overlooked  in  the  case  of  an  ordinary 
building.  Dampness  and  malaria  are  of  course  fatal  to  a  site  for  any 
purpose.  For  schools  we  must  plan  to  have  abundant  light  (much  more 
than  will  suffice  for  dwellings  and  shops) ,  and  to  have  the  sun's  direct 


66  SCHOOL  HYGIENE. 

rays  enter  each  room  at  some  time  of  the  day.  The  business  of  the 
school  requires  the  absence  of  noise, — a  point  which  may  be  overlooked 
in  business  edifices  ;  and  the  social  character  of  the  neighborhood,  and 
its  moral  nviisances,  are  also  to  be  considered. 

Da??zp7iess.  Without  going  much  into  details,  the  use  of  some  method 
of  drainage  and  of  some  shield  against  incoming  water  is  suggested,  as 
likely  to  be  needed  in  many  places.  The  cellar,  as  hygienists  know, 
ought  to  be  carefully  guarded  f"om  contamination  of  soil  and  air,  an,d 
should  at  all  times  be  dry.  Grading  will  suffice  to  keep  off  most  of  the 
surface  water.  Underground  water  may  be  provided  for  by  a  ditch,  dug 
outside  of  the  foundation  and  reaching  deeper  than  the  cellar  floor,  and 
either  laid  with  drain  tile,  or  filled  to  the  depth  of  a  foot  with  loose 
stones,  after  which  earth  is  thrown  in.  A  similar  trench  may  be  cut  in 
the  floor.  All  such  drains  are  to  be  led  to  a  proper  place  for  discharge. 
The  floor  may  be  made  damp-proof,  according  to  Col.  Waring's  sugges- 
tion, by  six  inches  of  well  rammed  clay,  or  by  asphalt  between  two  layers 
of  cement ;  the  foundation  walls  may  be  protected  by  a  coating  of  asphalt 
outside.  A  damp-proof  course  of  asphalt  in  the  walls  above  the  ground 
is  useful  in  preventing  moisture  from  rising. 

Small  country  schools,  if  without  a  cellar,  should  at  least  have  an  air- 
space underneath  the  floor,  with  a  few  openings  in  the  underpinning,  to 
give  ventilation  to  the  space. 

River  bottoms,  places  where  mist  is  often  seen,  and  the  neighborhood 
of  ponds,  are  undesirable  places  for  building.  No  business  is  more  inter- 
fered with  by  noise  than  that  of  school.  The  neighborhood  of  large  fac- 
tories, saw-mills,  foundries,  railway  stations,  engine-houses,  or  police 
stations,  is  therefore  to  be  avoided.  There  need  be  no  excuse  for  placing 
a  school-house  near  any  such  of  the  latter  as  are  under  public  control,  or 
for  utilizing  a  town  lot  by  putting  engine-houses,  school-houses,  and  a 
police  station,  in  close  neighborhood.  Regard  ought  to  be  had  for  the 
probable  growth  of  a  city,  and  avenues  likely  to  become  main  lines  of 
travel  should  be  avoided.  These  things  are  mentioned  because  they  are 
sometimes  strangely  disregarded.  In  large  cities  it  is  next  to  impossible 
to  procure  sites  which  fully  satisfy  the  demand  of  hygiene  in  respect  to 
the  supply  of  light.  Corner  lots  are  enormously  expensive,  besides  being 
noisy.  The  Sanitary  Engineer  prize  designs  for  public  schools,  pub- 
lished in  1880,  are  instructive  as  showing  that  in  the  opinion  of  the  prize 
committee, — 

"  The  most  essential  thing  in  a  public  school  is  sufficient  light.  The 
conditions  imposed  in  this  competition  make  it  impossible  to  secure  this 
light  without  either  overcrowding  of  class-rooms,  or  an  unsatisfactory 
arrangement  of  corridors,  stairs,  etc." 

"  Upon  so  restricted  a  site  as  that  contemplated^,  light  can  best  be 
secured  by  making  the  building  very  high,  higher  than  for  other  reasons 
is  desirable. 

i"A  lot  fronting  north,  of  100  feet  front  and  100  deep,  and  enclosed  by  buildings  on  adjoining  lots 
at  the  sides  and  rear,  of  average  city  height,  say  four  stories."     (Advertisement.) 


SCHOOL  HYGIENE.  6/ 

"  It  should  be  distinctly  understood  that  the  committee  do  not  recom- 
mend the  plans  to  which  they  have  given  awards  as  being  the  best 
designs  for  a  school  building,  but  only  as  the  best  plans  for  a  school 
building  to  be  built  in  a  huge  box,  lacking  one  side  and  without  a  top, 
the  sides  of  which  box  are  about  sixty  feet  high,  which  seem  to  be  the 
conditions  under  which  school  buildings  have  been  erected  in  New  York, 
and  in  which  from  1,500  to  2,500  children  have  been  crowded." — (San. 
Engineer^  March  i,  1880.) 

The  evil  complained  of  is  a  general  one.  New  York  is  not  the  only 
city  where  fine  new  school  buildings  are  erected,  with  a  pleasant  outlook 
all  around,  only  to  have  four-story  houses  placed  on  both  sides,  within  a 
dozen  feet  of  their  windows,  in  the  course  of  a  year  or  two.  This  is  one 
of  the  worst  failings  of  city  schools. 


2^.1 

Sttxra 

CIA3S. 

CldSf. 

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t 

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Cla^y 

CictAes 

Claa 

t 

CP'Zajj 

II.    PLAN  AND   ARRANGEMENT. 

Many  of  our  oldest  school  buildings  are  extremely  faulty.     In  fact,  we 
have  seen  two  reformations  in  school  architecture,  one  dating  from  the 

publication  of  Henry  Bar- 
nard'swork,in  1839,  while 
the  other  is  now  taking 
place.  The  progress  made 
within  a  few  years  past  has 
been  as  great  as  at  any 
other  period,  and  types  of 
edifices,  which  were  un- 
challenged models  of  ex- 
cellence fifteen  years  ago, 
are  now  superseded. 

several  rooms,  one  01  the 
CQTTi/jactness. 

*  commonest  faults  used  to 

be  the  parsimony  of  space,  which  cut  down  the  room  for  entries  to  a  min- 
imum, and  packed  class-room  behind  class-room  without  breathing  space. 
The  effect  of  this  was 
greatly  to  restrict  nat- 
ural ventilation.  Glass 
sliding  doors  were  very 
popular :  it  may  be 
feared  that  they  still  are 
in  some  places.  Spiral 
stairs  were  admired. 
Architectural  features, 
such  as  colonnades  and 
heavy  Greek  entabla- 
tures, are  still  seen  on 
some    older   buildings,  JPlo-n,  _  Scn-ue y<xuli. 

the  former  serving  to  cut  off  a  certain  part  of  the  light,  the  latter  taking 


ris 

2. 

CcrrioLor  andc  Stairs 

j^iye 

Class 

Rooms. 

68 


SCHOOL  HYGIENE. 


He 


s  / 


CLA 


/?  O 


SS 


OAKS 


Cla^a 


JZoom 


JDireoiorj 


Z?-oo?7t. 


up  space  in  the  wall  which  ovight  to  be  devoted  to  windows.  Excessive 
height  is  a  fault  which  is  only  just  beginning  to  be  remedied.     It  arises 

partly  from  a  false  taste  in  archi- 
tectuie,  partly  from  the  expensive- 
ness  of  land  in  cities. 

An  instance  of  the  excessively 
compact  style  of  building  is  given 
in  the  illustrations  (Figs,  i  and  2) , 
which  are  taken  from  the  Report 
of  the  New  York  State  Board  of 
Health  for  1881  ;  also  in  Fig.  3. 
Glass  sliding  doors  are  sup- 
T^io  3  P°^^^  t^  assist  in  lighting  rooms 
which  are  faultily  lighted  in  other 
respects.  They  are  far  less  effect- 
ual than  is  thought.  A  person 
standing  in  the  inner  room  looks 
out  through  the  glass  doors  upon 
well  lighted  rooms,  and  thinks  the 
light  he  sees  is  entering  the  room 
where  he  stands — a  false  impres- 
sion, which  should  be  corrected 
by  looking  the  other  way.  Light 
thus  transmitted  is  nearly  horizon- 
tal in  direction,  and  has  very  little 
Pl&iv  of  School.    PAiZa.deZp7t.ioy.-y  effect  in  brightening  the  page  of  a 

a  book  lying  on  a  desk.  Glass  also  reflects  some  light,  and  absorbs 
some.  In  short,  light  thus  obtained  is  not  good  light  for  the  purposes 
of  study.     The  rooms  in  Fig.  3  have  glass  partitions. 

Another  common  fault  in  plan  is  to  have  one  of  the  rooms  of  such 
dimensions  that  it  is  impossible  to  light  it  advantageously.  Such  very 
large  rooms  form  an  essential  part  of  many  high  schools,  even  of  modern 
construction ;  they  are  used  as  rooms  of  assembly,  and  also  as  the  gen- 
eral study  rooms,  each  pupil  having  a  desk  there,  and  only  leaving  it  as 
occasion  offers  to  go  to  small  recitation-rooms.  Such  rooms  are  usually 
lighted  from  the  right  and  left  sides.  The  width  between  the  windows 
is  sometimes  as  great  as  seventy  feet.  The  great  distance  of  the  windows 
from  the  central  parts  of  the  room  is  a  marked  disadvantage.  Twenty  or 
twenty-five  feet  is  as  far  as  a  desk  ought  to  be  from  the  window. 

Associated  with  this  foult, — or  independently, — may  be  found  a  defi- 
ciency in  the  size  of  recitation-rooms.  It  seems  to  be  supposed  that 
these  places  do  not  require  as  much  space  as  ordinary  class-rooms,  the 
fact  being,  that  they  are  apt  to  be  in  use  about  all  the  time,  and  therefore 
are  in  no  way  to  be  excepted  from  strict  requirements.  When  looking 
for  instances  of  bad  ventilation  and  overcrowding,  one  should  not  omit  to 
visit  these  rooms.  The  allowance  of  cubic  space  for  each  scholar  will  be 
mentioned  later. 


ifihhy    Q.n.dliSta.ir'S 


SCHOOL  HYGIENE.  69 

A  type  still  in  vogue,  which  has  some  decided  merits,  may  be  called 
the  four-square  plan.  It  contains,  on  each  floor,  four  rooms  and  a  corri- 
dor :  the  corridor  runs  from  front  to  rear,  and  the  rooms  are  in  pairs  to 

right  and  left.  There  is  a  stair- 
case in  front  and  rear.  Each  room 
is  lighted  from  one  side  and  the 
rear  of  the  scholars  :  each  room 
is  a  corner  room.  The  type 
which  is  likely  to  supersede  this 
one  is  based  on  the  wish  to  give 
more  light  and  ventilation  in  the 
corridors.  Both  are  illustrated 
(Figs.  4  and  5).  It  would  be 
rash,  however,  to  point  to  any 
one  plan  as  likely  to  have  exclu- 
M^S*^  sive  success. 

The  objection  to  spiral  stairs  is,  that  the  tread  is  very  narrow  on  the  side 
next  the  wall,  and  a  careless  person  easily  gets  a  severe  fall.  The  tread 
should  never  be  wedge-shaped.  It  is  a  good  plan  to  break  up  a  flight  of 
stairs  by  placing  a  landing  half-way,  with  a  full  turn.  Both  stairs  and 
corridors  must  be  well  lighted.     The  steps  must  be  easy  to  ascend. 

It  is  desirable  to  build  stairways  as  nearly  fire-proof  as  possible.  They 
may  be  enclosed  in  brick  walls,  so  that  fire  from  the  main  edifice  will 
reach  them  with  difficulty.  One  staircase  should  be  placed  at  each  end 
of  the  building,  so  that  no  room  need  be  cut  off"  by  smoke  or  flame  at  the 


J        L 

Stairs 

Siatrs 

1          1 

fifasw 

QSiiv. 

fftairf 

outbreak  of  fire  :  It  will  be  easy  to  go  a  step  further,  and  place  them  out- 
side, or  partly  outside,  of  the  building,  for  more  complete  isolation.  If 
the  framework  is  of  iron,  the  treads  may  be  of  hard  wood,  which  makes 
them  for  all  practical  puposes  fire-proof. 

These  precautions  are  among  the  first  to  be  taken  against  fire — we 
might  say  against  panic,  for  the  danger  to  life  from  fire,  in  a  school 
where  children  are  orderly,  is  scarcely  to  be  thought  of.  A  thousand 
children  can  be  got  out  of  a  large  school  within  two  minutes  of  an  alarm 


70  SCHOOL  HYGIENE. 

from  the  principal.  They  say  it  can  be  done  in  less  time ;  it  depends, 
however,  on  having  the  children  exercised  in  a  special  "  fire-drill,"  the 
sole  object  of  vv^hich  is  to  pass  them  out  as  quickly  as  possible.  In  the 
best  schools  this  drill  is  given  ivithout  warning-  once  a  month. 

Further  precautions  against  fire  may  be  taken :  they  ought  not  to  be 
limited,  however,  to  prevention  of  combustion,  but  should  include  some 
means  for  carrying  oft'  smoke,  which  is  so  apt  to  cause  panic.  To  this 
end,  it  is  proposed,  by  the  chief  engineer  of  one  of  our  large  cities,  to 
have  a  large  valve,  easily  opened,  at  the  roof,  so  as  to  draw  out  great  quan- 
tities of  air  or  smoke.  There  may  be  also  extra  flues,  built  in  the  parti- 
tion walls,  communicating  with  such  floor  spaces  or  wainscot  spaces  as 
may  be  supposed  likely  to  be  the  seat  of  fire.  The  flues  will  not  afford  a 
supply  of  air  to  the  flame,  but  will  only  carry  off"  the  smoke  and  gases 
instead  of  letting  them  come  through  the  floors.  The  writer  does  not  ex- 
press an  opinion  upon  these  suggestions,  but  they  rest  on  good  authority. 
Fire-proofing  beneath  the  floors  with  layers  of  plaster  is  certainly  to  be 
recommended  ;  also,  the  practice  of  bringing  the  floors  close  up  to  the 
walls,  thus  cutting  off'  the  connection  between  story  and  story,  which  is 
so  often  the  means  of  transmitting  a  fire  with  surjDrising  rapidity  to  the 
upper  stories.  Perhaps  the  chief  benefit  of  all  these  precautions,  as 
regards  safety  of  person,  lies  in  the  feeling  of  security  against  sudden 
conflagration,  which  will  give  confidence  in  the  moment  of  alarm  to  some 
teachers  who  might  otherwise  be  overpowered  by  sudden  dread. 

There  are  some  buildings  in  most  cities  which  were  never  meant  for 
schools,  but  which  are  crowded  with  poor  children,  whose  danger  would 
be  imminent  in  case  of  fire.  A  so-called  fire-escape,  placed  on  one  of 
these  wooden  traps,  affords  a  possible  means  of  safety,  but,  for  the  most 
part,  a  good  staircase  in  a  well  built  school-house  is  the  best  "  fire-escape." 

The  passages  to  be  passed  through  by  the  scholars  in  reaching  the  door 
should  be  wide  ;  the  outer  doors  should  swing  towards  the  street.  There 
should  be  two  doors  at  least, — one  for  each  staircase. 

The  competition  for  prizes  for  model  school-house  plans,  which  took 
place  in  1880  in  New  York,  has  already  been  mentioned.  The  condi- 
tions upon  which  the  committee  of  award  based  their  judgment  deserve 
to  be  quoted.  In  their  opinion  "  a  public  school  building  to  be  erected 
in  a  large  and  densely  populated  city,  should  possess  the  following  quali- 
fications, viz., — 

"  I.  At  least  two  adjoining  sides  of  the  building  should  be  freely  exposed 
to  light  and  air,  for  which  purpose  they  should  not  be  less  than  sixty  feet 
distant  from  any  opposite  building. 

"II.  Not  more  than  three  of  the  floors  should  be  occupied  for  class- 
rooms. 

"III.  In  each  class-room  not  less  than  fifteen  square  feet  of  floor  area 
should  be  allotted  to  each  pupil. 

"IV.  In  each  class-room  the  window  space  should  not  be  less  than 
one  fourth  of  the  floor  space,  and  the  distance  of  the  desk  most  remote 
from  the  window  should  not  be  more  than  one  and  one  half  times  the 
height  of  the  top  of  the  window  from  the  floor. 


SCHOOL  HYGIENE.  .  J I 

"V.  The  height  of  a  class-room  should  never  exceed  fourteen  feet. 

"  VI.  The  provisions  for  ventilation  should  be  such  as  to  provide  for 
each  person  in  a  class-room  not  less  than  thirty  cubic  feet  of  fresh  air  per 
minute,  which  amount  must  be  introduced  and  thoroughly  distributed 
without  creating  unpleasant  draughts,  or  causing  any  two  parts  of  the 
room  to  differ  in  temperature  more  than  2°  F.,  or  the  maximum  tempera- 
ture to  exceed  70°  F.  This  means  that  for  a  class-room  to  contain  fifty- 
six  pupils,  twenty-eight  cubic  feet  of  air  per  second  should  be  continu- 
ously furnished,  distributed,  and  removed  during  school  hours. 

"  The  velocity  of  the  incoming  air  should  not  exceed  two  feet  per  sec- 
ond at  any  point  where  it  is  liable  to  strike  on  the  person. 

"VII.  The  heating  of  the  fresh  air  should  be  effected  either  by  hot 
water  or  by  low  pressure  steam. 

"VIII.  The  fresh  air  should  be  introduced  near  the  windows;  the 
foul  air  should  be  removed  by  flues  in  the  opposite  wall. 

"IX.  Water-closet  accommodations  for  the  pupils  should  be  provided 
on  each  floor. 

"  X.  The  building  should  not  occupy  more  than  half  the  lot." 

The  only  comments  by  way  of  exception  that  need  to  be  made  upon 
this  are,  that  in  VI  it  seems  hardly  possible  to  expect  a  temperature  vary- 
ing only  two  degrees  all  over  a  room,  if  the  difference  between  ceiling 
and  floor  is  intended  to  be  included  ;  and  further,  that  the  method  of  intro- 
ducing fresh  warm  air,  etc.,  given  in  VIII,  is  not  the  only  desirable  one, 
as  will  be  shown  under  "Ventilation"  later  in  this  essay.  In  No.  IV 
the  size  demanded  for  windows  is  based  on  the  requirements  of  city 
architecture. 

In  other  respects  the  recommendations  deserve  unqualified  approval, 
as  embodying  the  chief  sanitary  requirements  in  a  city  school-house. 

Height  of  School  Buildings,  Not  merely  on  account  of  danger  from 
fire,  but  for  reasons  affecting  the  health  of  pupils,  excessive  height  has 
been,  within  a  few  years  past,  much  spoken  against.  It  seems  desirable, 
on  the  whole,  to  limit  the  height  to  three  stories,  of  which  the  first  two 
should  contain  most  of  the  school-rooms.  The  reasons  for  this  restric- 
tion are  such  as  apply  chiefly  to  girls  of  the  age  of  fourteen  and  upwards  ; 
more  especially,  to  young  ladies  in  normal  schools  and  seminaries.  Not 
to  enlarge  upon  this  point  here,  it  is  well  to  notice  the  unwillingness  of 
such  girls,  if  placed  in  the  upper  story,  to  descend  to  the  play-room  or 
yard  for  recess.  The  climbing  of  many  flights  is  an  evil  which  may 
come  about  in  another  way,  viz.,  when  scholars  study  in  one  story  and 
descend  to  another  for  each  recitation.  In  such  cases  the  need  of  con- 
sulting teachers  before  building  is  evident.  The  plan  of  the  house  should 
be  made  to  depend  on  the  plan  of  study,  and  architects  can  seldom  fail 
to  gather  some  useful  information  from  those  conversant  with  the  uses  to 
which  their  work  is  to  be  put. 

A  point  to  note  in  conclusion  is  the  smallness  of  the  yards  allotted  for 
the  children's  play  in  American  cities  as  compared  with  what  is  found  in 
Europe. 


72  SCHOOL  HYGIENE. 

III.    VENTILATION   AND   HEATING. 

This  is  one  of  the  chief  topics,  and  one  of  the  most  difficult,  connected 
with  School  Hygiene. 

It  is  comparatively  easy  to  build  a  convenient  and  spacious  house  :  the 
requirements  are  well  known,  the  cost  is  tolerably  definite,  for  a  given 
place  and  time.  The  problem  of  merely  heating  a  given  space  is  also 
one  of  moderate  difficulty.  But  ventilation  is  a  matter  about  which  a 
general  opinion  is  hardly  yet  formed,  and  the  cost  of  which  is  very  vaguely 
known.  People  in  general  are  not  yet  agreed  as  to  what  constitutes  good 
ventilation — how  much  fresh  air  per  hour  is  required. 

Between  a  barely  tolerable  system,  eked  out  by  opening  windows,  and 
a  system  which  really  furnishes  a  supply  of  from  thirty  to  sixty  cubic  feet 
of  fresh  warm  air  per  head  and  minute,  there  are  many  shades  of  differ- 
ence. Few  have  a  mastery  of  the  somewhat  complicated  questions  in- 
volved ;  very  few  have  seen  successful  and  logical  experiments  made  ; 
and  many  are  called  on  to  act  as  judges — to  act  upon  an  opinion  which 
they  cannot  have  formed. 

Amount  of  Fresh  Air  and  Cubic  Space  Required.  It  is  unfortunate 
that  authorities  differ  so  widely  on  these  points.  The  New  York  Metro- 
politan School  Board  sets  the  minimum  allowance  of  space  per  head  at 
from  70  to  100  cubic  feet,  according  to  age.  Fortunately,  this  does  not 
represent  the  general  practice  in  that  city, — though,  to  the  eye,  the  appear- 
ance of  many  infant  classes  suggests  the  idea  of  sardines  in  a  box.  Most 
authorities  would  wish  to  double  these  figures,  at  least. 

According  to  recent  inquiries  in  Boston,  there  is  no  corresponding  law 
or  regulation  ;  but  it  is  customary  to  build  rooms  for  fifty-six  pupils,  with 
an  allowance  usually  ranging  from  160  to  220  cubic  feet  per  head.  Prof. 
Kedzie,  of  Michigan,  claims  300  cubic  feet;  A.  C.  Martin,  220  ;  various 
German  states,  from  120  to  284.  The  Conseil  Sup6rieur  a  Hygiene  Pub- 
lique,  in  a  recent  report  to  the  Belgian  Ministry  of  the  Interior,  recom- 
mends a  minimum  of  6f  cubic  metres  per  head,  or  about  240  cubic  feet, 
a  space  which  requires  the  unusual  height  of  4^  metres,  or  about  14  ft.  10 
in.  The  high  position  of  the  sanitary  service,  especially  as  regards 
schools,  in  Belgium,  lends  weight  to  their  recommendation. 

It  is  the  writer's  belief  that  it  is  desirable  to  limit  the  size  of  classes  to 
forty  (40)  pupils.  Experts  in  education  recognize  the  gain  that  accrues 
to  the  individual  scholar  from  such  limitation.  If  we  base  the  calcula- 
tion on  this  figure,  we  have  more  liberty  of  choice  between  large  and 
small  rooms  in  making  our  plan  for  a  building.  The  advantage  of  space 
is  twofold  ; — it  enables  us  to  introduce  lai-ge  volumes  of  air,  fresh  and 
warm,  without  danger  of  draughts ;  and  it  gives  more  value  to  the  prac- 
tice of  airing-out  the  room  by  windows  at  recess  times,  since  a  large 
roomful  of  fresh  air  lasts  longer  than  a  small  one.  But  there  is  such  a 
thing  as  too  much  space,  entailing  difficulties  in  regard  to  discipline  and 
teaching,  and  making  it  hard  to  secure  good  light.  For  example,  a  class 
of  fifty-six,  with  an  allowance  of  250  cubic  feet  each,  requires  a  room  of 


SCHOOL  HYGIENE.  73 

the  capacity  of  14,000  cubic  feet,  or  37  feet  wide,  37  long,  and  14  high, 
dimensions  which  can  hardly  be  profitably  exceeded,  if  indeed  they  are 
not  too  great  already. 

As  regards  the  amount  of  fresh  air  to  be  introduced  hourly,  it  is  desir- 
able to  found  our  ideal  upon  the  basis  of  Parkes  &  DeChaumont's  views, 
which  represent  the  best  authority.  By  depending  upon  the  testimony 
of  their  senses  as  to  whether  rooms  were  "close"  or  "fresh,"  these 
authorities  reached  the  conclusion  that  it  is  not  desirable  to  allow  the 
amoimt  of  carbonic  acid  in  air  to  exceed  the  proportion  of  6  parts  in 
10,000.  Any  higher  proportion  seemed  to  be  attended  with  perceptible 
closeness. 

Now,  assume  that  fresh  air  from  out  of  doors  contains  '^\  parts  in 
10,000,  which  is  a  trifle  below  the  usual  rate.  A  room  of  the  capacity 
of  10,000  cubic  feet,  freshly  filled  with  this  air,  and  tenanted  by  one  man, 
would  receive  from  his  lungs  an  addition  of  2^  cubic  feet  of  carbonic  acid 
in  4^  hours,  raising  the  total  to  6  cubic  feet.  If,  then,  10,000  cubic  feet 
will  last  /\\  hours,  the  supply  for  one  hour  should  be  2,400  cubic  feet,  or 
for  one  minute,  40  cubic  feet. 

The  usual  assumption  is,  that  "  fresh  "  air  contains  4  parts,  not  3I-,  in 
10,000.  If  so,  the  hourly  requirement  is  about  3,000  cubic  feet,  or  50 
per  minute.  Billings  increases  this  to  60.  If  an  average  school-room  of 
the  better  class  contains  an  allowance  per  scholar  of  200  cubic  feet  of 
space,  there  would  be  a  necessity  for  renewing  the  air  completely  every 
four  minutes,  or  fifteen  times  in  an  hour.  This  requirement,  however, 
is  intended  to  apply  to  rooms  used  day  and  night,  such  as  barracks.  For 
school-rooms,  the  amount  may  be  less,  owing  to  the  opportunities  for 
frequent  airing,  and  the  total  disuse  out  of  school  hours.  The  writer 
agrees  v/ith  Dr.  Billings  in  the  belief  that,ycir  schools.,  the  allowance  of 
from  23  to  JO  cubic  feet  j[)er  minute  and  head  will  answer  all  needful 
purposes,  if  supplemented  by  occasional  airing-out  during  and  after 
school. 

It  is  evident  that  if  air  is  to  be  introduced  so  rapidly,  there  should  be 
a  liberal  allowance  of  room,  in  order  that  the  incoming  air  may  not  be 
felt  as  a  draught.  The  outgoing  air,  by  the  way,  is  rarely  felt ;  but  a 
very  vigorous  draught  may  be  appreciable  two  feet  from  the  register. 

Do  children  require  a  stnaller  allowance  than  adults?  or..  Do  small 
children  require  less  than  large  ones? 

One  answer,  in  the  affirmative,  is  derived  from  the  estimates  of  the 
amount  of  CO2  exhaled  at  different  ages.  Breiting  gives  it,  for  girls  aged 
seven  or  eight  years,  at  a  little  over  10  litres  per  hour  ;  at  the  age  of  eight 
or  nine,  12  litres.  If  engaged  in  singing,  it  is  16.7  for  the  latter  age. 
Boys  aged  twelve  or  thirteen  expire  13  litres  ;  during  singing  the  amount 
rises  to  17.  Scharling  gives,  for  the  age  of  ten  years,  close  upon  10  litres  ; 
for  a  boy  of  sixteen,  17.4;  for  a  young  woman  of  seventeen,  12.9;  for 
adults,  a  little  more.  Pettenkofer  &  Voit  give  16.8  for  a  weak  man,  and 
22.6  for  a  strong  man. 

It  would  appear,  then,  that  there  is  a  decided  difference  to  be  allowed 


74  SCHOOL  HYGIENE. 

for.  Primary  pupils  expire  less  CO2  than  high  school  pupils,  in  the  ratio 
of  3  to  3  ;  or  perhaps  the  difference  is  still  greater.  If  a  room  ought  to 
contain  the  cubic  space  of  250  feet  per  head  for  larger  scholars,  it  need 
contain  only  iSo  for  the  same  number  of  small  scholars.  In  other  words, 
forty  large  and  sixty  small  scholars  can  be  accommodated  in  an  equal 
space. 

This  estimate,  however,  is  admissible  only  on  the  supposition  that  the 
ventilation  is  efficient.  In  case  of  defect,  or  apprehended  defect  (and  this 
covers  a  wide  ground) ,  the  young  children  should  have  equal  room  with 
the  older  ones,  on  the  ground  of  their  comparative  inability  to  cope  with 
the  deleterious  effects  of  bad  air  ;  also,  because  in  contracted  quarters  the 
danger  of  draughts  from  windows  is  greater.  It  has  been  said  that  chil- 
dren need  a  proportionately  large  allowance,  "because  metamorphosis 
of  tissue  goes  on  more  rapidly  in  them."  We  have  two  means  of  esti- 
mating the  amount  of  tissue-change, — the  quantity  of  CO3  exhaled,  and 
the  quantity  oifood  consumed.  On  the  whole,  the  latter  item  is  suffi- 
cient for  the  argument,  and  may  be  believed  to  represent  the  amount  of 
change  of  tissue  very  well.  It  is  quite  evident  that,  though  boys  of  fif- 
teen may  consume  as  much  food  as  men,  children  of  eight  do  not.  A 
supply  of  air,  then,  which  would  be  liberal  for  a  large  boy,  would  be 
more  than  liberal  for  a  small  child.  The  degree  of  allowance  to  be  made 
is  a  point  upon  which  distinguished  authorities  differ.  DeChaumont 
would  place  three  times  as  many  children  of  four  or  five  years  in  a  given 
room  as  youths  of  fifteen  or  sixteen,  while  Billings  would  allow  very 
nearly  the  same  amount  for  children  of  all  ages. 

Dimensions  of  Ventilating  Apparatus.  Let  us  suppose  the  case  of 
a  school-house  to  be  planned  for  thorough  ventilation.  It  is  assumed  that 
all  the  air  to  be  extracted  is  to  be  carried  by  flues  through  the  roof.  We 
will  first  consider  the  flues  for  extraction.  The  resistance  offered  by 
friction  is  of  great  importance,  and  should  lead  us  to  make  the  flues  of 
liberal  size,  as  straight  as  possible,  and  smooth  internally.  A  flue  of  less 
than  eight  inches  internal  diameter  is  not  worth  much.  The  inside 
should  be  finished  in  smooth  plaster,  or,  better,  with  sheet  metal ;  never 
with  rough  brick  unless  very  large.  Angles  check  momentum  very 
greatly  ;  so  do  horizontal  passages. 

Suppose  a  single  room  to  be  ventilated  by  a  single  brick  flue,  straight 
and  well  made  ;  and  suppose  the  only  force  to  produce  a  current  is  the 
warmth  of  the  air  leaving  the  room  at  68°.  It  is  probable  that  if  the  flue 
is  of  moderate  height,  With  no  fire,  the  upward  draught  will  seldom  ex- 
ceed the  rate  of  two  feet  per  second.  An  average  of  two  would  be  a 
liberal  allowance.  If  there  are  fifty-six  pupils,  the  chimney  is  expected 
to  discharge  28  cubic  feet  per  second,  and  in  order  to  do  this,  it  must  be 
at  least  14  feet  in  sectional  area,  or  about  4  by  3^  feet  inside  measure. 
The  register  opening  to  this  flue  should  be  at  least  as  large.  (The  reader 
may  try  to  form  an  idea  of  this  by  measuring  the  dimensions  on  the 
wall.) 

Not  to  speak  of  the  register,  such  large  flues  cannot  be  introduced  into 


SCHOOL  HYGIENE. 


75 


a  building  already  finished,  and  can  hardly  be  thought  of  in  a  new  plan. 
There  is,  indeed,  no  necessity  of  so  large  a  shaft  if  we  provide  a  some- 
what different  arrangement. 
If  convenient,  we  can  cause 
the  furnace-smoke  to  be  car- 
ried up  this  flue  in  a  cast-iron 
pipe,  thus  increasing  the  heat, 
and  possibly  doubling  the  ve- 
locity. In  large  buildings, 
moreover,  the  whole  system 
must  be  centralized,  and  this 
is  done  in  two  ways, — first, 
by  conducting  the  foul  air 
from  each  room  by  long  tubes 
to  a  central  heated  chimney  ;  and  second,  by  grouping  rooms  so  that  they 
discharge  their  foul  air  at  once  into  the  chimney,  without  intervening 

"ducts."  The  latter  is  the 
plan  of  the  Bridgeport,  Conn., 
high  school,  to  be  described 
presently. 

Three  illustrations  (Figs. 
6,  7,  and  8)  show  how  the 
Ti^'lt  ^^st  plan  may  be  carried  out. 
It  is  to  be  observed  that  they 
all  imply  the  expenditure  of 
extra  heat  to  force  a  draught ; 
'also  that  in  No.  6  the  heat  is 


^/^.a> 


applied  in  a  chamber  in  the  attic  (which  may  be  of  wood  lined  with  sheet 
metal) ,  while  in  the  others  it  is  imparted  by  the  smoke-flue  of  the  furnace. 
The  most  economical  plan  ^-f-^ 

of  the  three  is  stated  by  -  5     ^ 

Planat  to  be  the  last ;  the 
least  economical,  the  first. 
The  Bridgeport  school 
plan  is  illustrated  in  the 
next  plan  (Fig.  9) ,  It  is 
ventilated  by  two  large, 
brick  shafts,  which  curve 
and  meet  in  one  at  the 
attic  story.  In  their  up- 
ward course  they  pass  di-  ■ 
rectly  by  each  school-room,  and  take  foul  air  by  one  large  opening  from 
each.  These  same  shafts  also  carry  the  tin  flues  for  the  hot  air  supply 
of  the  rooms,  one  such  flue  for  each  room.  The  heat  lost  from  the  tins 
goes  to  keep  up  the  heat  of  the  shaft,  and  increase  the  ' '  suction  "  power. 
The  smoke-flue  is  utilized  in  the  same  way,  and  there  is  a  "  suction  coil" 
for  extra  heat  in  the  upper  part  of  the  flue. 


76  SCHOOL  HYGIENE. 

With  but  one  inlet  and  one  outlet,  there  was  need  for  special  care  in 
planning  the  position  of  the  registers.  The  plan  adopted  seems  to  be 
quite  successful  in  distributing  the  air  and  equalizing  the  temperature. 
The  inlet  for  hot  fresh  air  is  near  the  ceiling  :  the  current  travels  towards 
the  windows  :  a  descending  current  near  the  windows,  originating  in  the 
cooling  effect  of  the  glass,  continues  the  movement,  and  finally  there  is 
a  strong  outward  movement  of  air  at  the  inner  corner  of  the  room  on  the 
level  of  the  floor.  Something  like  a  circular  movement  is  thus  produced. 
In  the  diagram  (Fig.  lo)  arrows  are  introduced  at  points  where  currents 
are  felt,  and  the  intervening  points  may  be  filled  in  by  the  reader's  judg- 
ment.    The  figure  represents  the  room  in  section,  with  temperature  taken 


Mff,  9. 


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EXITS    FSf^   fflJR 


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IfJJjOM 


ro/.'a     A  I  R 


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/Room 


^  ^   *^    COi-O      >77 


BRLDOePORT^  JCCStCN, ,  Mi G^    SCHXfQ Z.« 

simultaneously  after  the  apparatus  had  been  in  operation  forty-five  min- 
utes. Similar  arrangements  have  been  since  made,  to  the  knowledge  of 
the  writer,  in  schools  in  Auburn,  New  York,  and  Newton,  Mass.,  with 
good  success. 

The  orifice  for  the  exit  of  foul  air  ought  to  be  a  good  deal  larger  than 
that  for  the  inlet  of  fresh  air.  In  examining  Fig.  9,  the  reader  is  desired 
to  make  the  correction  mentally. 


SCHOOL  HYGIENE. 


77 


The  use  of  steam  power  as  a  ventilating  agent  is  not  a  novelty  in  other 
public  buildings,  but  in  school-houses  it  has  been  tried,  so  far  as  known 
to  the  writer,  only  in  Boston,  and  that  within  a  few  weeks  past.  The 
experiment  is  one  which  it  is  very  desirable  to  make,  by  way  of  testing 
its  economical  value.  The  arrangement  consists  of  a  fan  placed  in  the 
space  below  the  ridge-pole,  within  a  box,  propelling  the  air  .upwards 
through  the  cupola,  and  exhausting  by  good-sized  flues  from  below.  The 
motor  is  a  high-pressure  engine  in  the  cellar,  which  seems  to  require 


iZft. 


ar 


65* 


e/f.  no" 


^ft 


IS*     7V 


PLATFORf^ 
73* 


75»  7«" 


70"     69" 


\ 
IS"   r& 


BRIDGEPORT       HIGH    SCHOOL 
VerlioaZ  Section    of  a.  HooTJt.^iS'/iiSgiitStTimpsSSlfOtB^ 
ai  AeiQhi    of    I  in.c7t^5Ffeei^  Bfeet^  I2j&ei^fi-ant /Isar 

from  twelve  to  fifteen  tons  of  coal  during  the  winter,  and  the  constant 
presence  of  an  engineer.  A  new  form  of  engine  ("vacuum  engine")  is 
proposed,  requiring  no  separate  fire,  and  run  by  jets  of  steam  from  the 
boiler  which  heats  the  school,  at  an  extremely  low  pressure.  No  tests 
for  carbonic  acid  have  been  made,  but  the  anemometer  test,  applied  in 
two  schools,  gave  a  rate  of  discharge  equivalent  to  twenty-four  cubic  feet 
per  head  and  minute,  which  is  about  as  much  as  we  can  ask  for.  The 
expense  of  introducing  the  appliances  is  stated  as  moderate  ;  flues,  not  to 
be  considered,  being  required  in  any  case  ;  vacuum  engine  (no  boiler 
required) ,  about  $500  ;  and  fan,  something  more,  besides  cost  of  gearing 
to  transfer  power  from  cellar  to  attic.  In  one  school  a  certain  amount  of 
rumbling  noise  is  heard  (but  not  complained  of),  due  to  vibrating  motion 
in  the  attic,  the  apparatus  having  been  introduced  not  as  part  of  the 
original  plan,  but  after  the  school  was  built.  In  the  other  building 
scarcely  any  sound  was  heard. 

The  arrangement  of  flues  for  such  a  plan  has  nothing  peculiar.  It 
requires  chiefly  the  avoidance  of  angles,  or  rough  and  narrow  flues,  and 
is  represented  in  figure  6,  the  fan  being  placed  at  ****,  just  below  where 
the  cupola  is  set  upon  the  roof. 

No  system  for  exhausting  air  by  hot  flues  or  by  steam  power  should  be 
introduced  without  providing  for  the  introduction  of  a  corresponding 
amount  of  fresh-warmed  air.     Hence  it  follows  that  ventilation  and  heat- 


78  SCHOOL  HYGIENE. 

ing  constitute  parts  of  one  general  problem,  and  that  the  same  mind 
should  plan  both. 

"  Indirect"  heating  is  the  only  kind  worthy  of  our  consideration.  In 
cases  where  stoves  are  set  in  school-rooms,  they  should  be  made  indirect 
heaters  by  the  use  of  screens,  as  is  hereafter  described.  For  larger  build- 
ings, steam  heat,  by  means  of  coils  arranged  in  boxes  in  the  basement,  is 
probably  the  best.  Auxiliary  coils  may  be  placed  in  entries,  but  not,  as 
a  rule,  in  school-rooms.  Ventilation  cannot  be  had  without  some  in- 
crease in  the  bills  for  fuel.  There  is  reason,  however,  to  think  that  the 
amount  of  inci"ease  is  not  so  great  as  might  appear.  In  our  worst  venti- 
lated schools  there  is  a  good  deal  of  warmed  air  let  out  at  windows,  in 
an  unsystematic  way. 

Good  ventilation  implies  that  cold  draughts  from  open  windows  are 
done  away  with  :  hence  a  lower  degree  of  heat  in  the  room  is  sufficient 
for  comfort.  It  also  implies  a  rapid  change  of  air,  with  equalization  of 
temperature,  so  that  the  feet  are  kept  warm  :  this  also  enables  us  to  be 
comfortable  at  a  low  temperature.  A  third  point,  bearing  in  the  same 
direction,  is  the  greater  activity  of  the  circulation  and  of  the  change  of 
bodily  tissue,  and  the  consequent  increase  of  bodily  warmth  in  fresh  air. 

The  writer  has  at  least  twice  found  opinions  strongly  expressed  in  favor 
of  the  results  of  ventilation.  Once  in  a  new  primary  school  at  Springfield, 
Mass.,  v^^here  the  teachers  agreed  that  they  could  get  along  with  the  ther- 
mometer some  degrees  lower  in  their  new,  well  ventilated  quarters,  than 
formerly  was  the  case  in  close  rooms.  The  other  instance  points  indi- 
rectly in  the  same  way.  In  the  new  building  of  the  Massachusetts  Insti- 
tute of  Technology,  with  nearly  perfect  ventilation,  the  quality  of  the 
work  performed  is  said  to  be  decidedly  superior  to  that  which  was  done 
in  the  old  building,  which  has  no  system  worth  naming.  The  ventilation 
in  the  new  Institute  building  is  very  successful.  It  is  effected  by  a  fan  in 
the  basement,  which  forces  air  through  openings  in  the  inner  walls  of  the 
rooms  at  a  high  point,  the  air  escaping  by  flues  in  outer  walls  at  low 
levels.  The  allowance  per  hour  and  head  is  1,500  cubic  feet  in  lecture- 
rooms,  and  from  2,000  to  4,500  in  laboratories  of  various  kinds.  The 
analyses  of  air  gave  from  4.87  to  5.23  parts  CO2  in  10,000,  in  a  room 
which  was  half  full  of  students.  The  estimate  for  a  full  room  would  be 
from  7  to  8  parts  per  i  ,000.  Corresponding  analyses  in  the  old  building 
gave  from  9  to  12.34  in  a  room  with  doors  and  windows  open,  half  full ; 
if  filled  it  would  pi'obably  stand  at  21  or  22  in  10,000.  Prof.  Wood- 
bridge's  estimate  of  the  fuel  burned  last  winter  is  307  tons  for  the  old  and 
404  for  the  new  building,  and  some  allowance  is  to  be  made  for  the  fact 
that  all  the  boilers  are  situated  in  the  cellar  of  the  older  building.  Both 
are  of  nearly  the  same  size,  and  are  equally  used,  and  for  the  same  pur- 
poses. 

However  encouraging  these  results,  it  is  seen  that  perfection  is  not  yet 
reached.  Byway  of  comparison,  a  few  selected  data  are  given,  showing 
the  number  of  jDarts  in  10,000  of  CO2  in  the  air  of  various  localities.  (See 
table.) 


SCHOOL  HYGIENE. 


79 


It  is  probable  that  the  bad  air  of  German  schools  is  one  cause  of  the 
prevalence  of  near  sight  and  other  defects  of  vision. 

The  standard  of  6  per  10,000  is  not  likely  to  be  reached  in  schools  at 
present.  Perhaps  we  shall  have  to  admit  the  practical  justice  of  Prof. 
W.  R.  Nichols's  remark,  that  10  in  10,000  is  as  low  as  we  can  expect  to 
find  in  schools  with  fair  ventilation. 


AMERICAN   SCHOOLS. 


Philadelphia . . . 

Boston 

Boston 

Boston 

Michigan 

New  York  city. 
Lynn,  Mass. . . . 


,187s 
,1870 
.1875 


.1873 
1883 


No.  of 

rooms 

examined. 


9 

40 

III 

39 
46 
17 


Parts  CO 2 
in  10,000. 


14.5 
11.9 
iS-6 
22.9 

20.8 
17-5 


Observer. 


E.  Thompson. 
'  A.  H.  Pearson. 
Draper  &  Nichols. 
W.  R.  Nichols. 
R.  C.  Kedzie. 
H.  Endemann. 
Prof.  Hills. 


GERMAN    SCHOOLS. 


Annaberg,  5  schools 

Wilhelm's  Gymnasium  in  March. 

«  "  in  July... 

Celle,  Gymnasium,  various  rooms . 

Celle,  Volks-schulen,  most  rooms. 

"  "  one  room. . . 


39-9 

0.  Krause 

55-8 

Oertel. 

22.9 

" 

20.50 

Baring. 

90 

« 

120 

ft 

Much  has  been  said  regarding  the  proper  position  for  outlets  and 
inlets  for  air.  One  false  view  may  be  corrected  at  once, — the  notion  that 
carbonic  acid  gas  is  the  agent  that  is  chiefly  noxious,  and  that  this  gas 
seeks  the  lower  levels.  It  is  not  specially  dangerous  in  quantities  found  in 
schools — the  animal  vapors  from  skin  and  lungs  are  more  so — but  it  repre- 
sents the  degree  of  organic  pollution  fairly  well.  It  is  not  found  chiefly  at 
a  low  level.  If  there  is  any  difference,  the  upper  levels  are  sometimes  more 
impregnated,  owing  to  the  breath  rising  in  a  cool  room  ;  but  the  differ- 
ence is  small,  and,  in  a  room  with  rapid  ventilation,  not  distinctly  trace- 
able. The  air  from  the  pupils'  lungs  may  be  assumed  to  be  distributed 
through  the  apartment  rather  quickly.  The  process  of  ventilation  then 
becomes,  not  a  removal  of  the  exhaled  air,  but  a  dilution  by  the  introduc- 
tion of  large  quantities  of  fresh  air. 


So  SCHOOL  HYGIENE. 

A  test  for  carbonic  acid  is  not  easily  made  in  a  way  to  satisfy  scientific 
demands,  but  an  approximate  test  can  be  made  in  a  minute  by  an  un- 
skilled person.  An  ounce  of  fresh  lime-water  in  a  ten-ounce  bottle  of 
the  air  to  be  tested,  shaken  vigorously  for  half  a  minute,  will  indicate  a 
fair  degree  of  purity,  if  it  is  not  distinctly  made  turbid.  One  should  have 
a  little  practice,  even  at  this  simple  operation. 

The  writer  has  endeavored  to  make  a  convenient  and  portable  appara- 
tus which  will  give  an  indication  of  the  number  of  parts  in  10,000,  within 
a  range  of  error  not  exceeding  one  part.  To  some  extent  the  instrument 
is  successful.  It  is  based  on  Lange's  method.  A  series  of  bottles  of 
known  size  was  chosen,  graded  from  large  to  small,  and  fitted  in  a 
wooden  frame.  The  whole  apparatus  is  carried  to  the  room  to  be  tested. 
The  bottles  have  been  previously  filled  with  water,  and  when  inverted  the 
air  fills  them  at  once.  They  are  stoppered,  and  carried  to  the  laboratory, 
where  a  given  amount  (say  one  half  ounce)  of  lime-water  (chosen  as 
being  less  liable  to  change  than  baryta-water)  is  introduced  into  each, 
and  also  a  few  drops  of  a  solution  of  phenolphthalein,  which  gives  a  rose 
color  to  the  lime-water.  By  shaking  for  a  good  many  minutes  the  car- 
bonic acid  is  made  to  neutralize  the  lime  ;  the  approach  of  complete  neu- 
tralization is  marked  by  the  fading  of  the  rose  color  ;  and  when  satisfied 
that  the  process  has  gone  on  long  enough,  we  select  the  largest  bottle  that 
shows  the  complete  change,  and  say, — 

The  air  in  this  bottle  measures  (say)  10  ounces  ;  it  contains  enough 
CO2  to  neutralize  (say)  \  ounce  of  lime-water  :  how  much  CO2  is  here  "i 
and  how  many  parts  in  10,000  parts  of  air  does  it  stand  for? 

The  calculation  is  of  course  made  previously  for  each  bottle,  so  as  to 
reduce  the  labor  of  a  test  to  the  mechanical  operation.  The  act  of  shak- 
ing is  fatiguing,  and  the  charging  of  the  bottles  i-equires  some  practice, 
and  a  well  graduated  tube.  No  figures  are  here  given,  but  by  a  com- 
parison with  simultaneous  analyses  made  by  Pettenkofer's  method,  an 
encouraging  degree  of  accuracy  has  been  observed.  The  point  of  diffi- 
culty in  this  and  similar  processes  is  to  determine  when  the  carbonic 
acid  is  to  be  considered  as  having  been  fully  taken  up  by  the  lime.  This 
fault  seems  to  attach  to  Mr.  Owen's  ingenious  process,  given  in  Billings's 
"Ventilation  and  Heating." 

Source  of  Supply  of  Air.  The  purity  of  the  source  must  be  carefully 
o-uarded.  A  wooden  duct  is  the  usual  means  of  conveying  the  air  across 
the  cellar  to  the  furnace.  Such  ducts  easily  open  at  the  joints,  and  let  in 
cellar  air  :  hence  painting  from  time  to  time  may  be  useful,  unless  tin  be 
substituted,  or  galvanized  iron.  The  interior  should  be  accessible  in  some 
way  for  cleaning,  as  dust  cannot  but  accumulate  with  time.  The  inlet, 
out  of  doors,  is  to  be  guarded  with  a  wire  screen,  and  is  so  situated  as 
to  be  out  of  the  way  of  mischievous  persons.  Bad  smells  are  sometimes 
noticed  in  a  school,  which  enter  through  this  channel.  It  is  hard  to  tell, 
in  certain  neighborhoods,  just  where  to  place  the  opening.  The  ground 
is  damp  ;  the  air  at  ten  feet  is  odorous  for  various  reasons  ;  and  at  thirty 
feet  the  smoke  of  neighboring  chimneys  is  blown  into  the  inlet ; — it  is 


SCHOOL  HYGIENE. 


usual,  however,  to  make  the  cautionary  remark  that  malaria  and  damp- 
ness linger  near  the  ground,  and,  as  a  rule,  ten  feet  from  the  ground  is  a 
good  place. 

Scrupulous  cleanliness  of  the  cellar  is  necessary.  If  there  are  water- 
closets  there,  they  had  better  not  be  near  the  ducts,  nor  even  in  the  same 
division  of  the  cellar,  since  the  ducts  are  provided  with  doors  which  are 
liable  to  be  left  open  contrary  to  orders.  The  misuse  of  such  valve-doors 
is  one  of  the  crying  sins  of  janitors.  Many  a  master  has  a  perpetual  war- 
fare with  this  functionary  on  account  of  this.  The  janitor's  object,  first 
and  last,  is  the  saving  of  coal  in  order  that  he  may  receive  credit  for 
economy,  and  his  habit  is  to  close  the  outer  valve,  opening  the  one  that 
leads  from  the  cellar,  thus  feeding  his  furnace  or  coils  v^ith  cellar  air  at 
60°  instead  of  the  cold  air  out  of  doors.  In  this  way  the  winter  has  found 
a  school-house  filled  with  air  which  must  have  passed  through  the  fur- 
nace two  or  three  times,  being  drawn  down  through  the  entries  to  the 
cellar,  and  then  sent  back  through  the  furnace.  Excessive  heating  of  the 
air  is  not  so  frequent  a  fault  at  present  as  formerly.  A  report  made  to 
the  Boston  school  board  in  1846  complains  that  the  air  sent  to  school- 
rooms is  frequently  heated  to  500°  or  600°.  This  may  be  simple  exag- 
geration, but  there  is  no  doubt  that  a  heat  approaching  200°  is  not  un- 
common at  present.  Circumstances  alter  the 
requirements  greatly,  but  for  schools  by  day- 
light, the  range  should  not  much  exceed  1 20° 
F.,  nor  fall  much  below  80°.  In  order  to 
fulfil  this  demand  furnaces  and  boilers  should 
be  made  very  large.  Steam  heating  is  one 
of  the  best  methods.  The  pressure  upon  a 
boiler  of  proper  capacity  need  never  exceed 
ten — perhaps  it  should  not  exceed  five — 
pounds  to  the  square  inch,  and  it  should 
frequently  run  down  to  one  pound.  The 
danger  of  explosion  need  hardly  enter  into 
the  calculation  if  there  is  good  management. 

Ventilating- Stoves.     A  useful  apparatus 
for  aiding  ventilation  is  furnished  by  a  class 
of  stoves  which  are  provided  with  an  inlet  for  fresh  air,  and  a  chamber 
for  warming  it  before  it  is  introduced  to  the  room. 

Figure  1 1   shows  a  stove  having  a  jacket  of  sheet  metal,  a  space  be- 
tween the  jacket  and  stove,  and  a  fresh-air 


^s^. 


D 


yl^  ea:&Ji-§y 


r^ 


Fis.lB. 


flue,  with  a  valve  operated  from  the  room. 
i^sn.l^&^  ^^^  principle,  as  regards  air-supply,  is  not 
essentially  different  from  that  of  the  "Fire 
on  the  Hearth,"  the  "  Jackson  Ventilating 
Grate,"  and  Galton's  ventilating  fire-places. 
The  method  is  practically  valuable,  though 
the  stoves  I  have  seen  do  not  really  supply 
enough  air ;  that  is,  a  stove  large  enough 


82 


SCHOOL  HYGIENE. 


Fig.  I'd. 


a 


Em 

77 — ^ 


to  heat  a  given  room  does  not  introduce  nearly  enough  air  to  ventilate 
it.  The  column  of  hot  air  is  very  short,  and  the  velocity  moderate. 
Yet,  where  stoves  are  to  be  used,  there  is  an  obvious  gain  in  using  this 
kind.     It  ought  to  be  supplemented  by  a  pow^erful  chimney-draught,  the 

chimney  being  made  of  liberal 
size,  and  heated  by  the  passage 
of  the  stove-pipe  :  an  opening 
for  ventilation  is  to  be  made 
near  the  floor.  In  still  other 
ways  ventilation  may  be  aided 
by  the  stove-pipe,  as  vs^ill  be 
seen  from  Figs.  13  and  14. 

Figure  13  shows  a  screen 
(supposed  to  form  a  semicir- 
cle) placed  by  a  stove  near  a 
window,  which  is  opened. 

Figure  13  is  like  Fig.  11  in 
principle. 

Figure  14  shows  how  a  low- 

Ier  story  may  be  ventilated. 
The  last  four  illustrations  are 
from  Billings's  "Ventilation  and  Heating." 

The  evaporation  of  water  in  connection  with  heaters  is  probably  useful, 
but  the  writer  is  not  inclined  to  consider  the  matter  one  of  primary  im- 
portance. It  is  successfully 
dispensed  with  in  some  of 
the  best  ventilated  new  wards 
in  hospitals. 

Children  often  come  in 
with  cold  and  damp  feet. 
It  is  desirable  to  provide 
some  kind  of  foot-warmer 
in  the  hall  or  basement.  A 
good  one  is  made  of  an  iron 
plate,  2\  or  3  inches  thick, 
set  on  a  flat  steam-coil. 

Opening  Windonvs.  This 
may  be  regarded  in  two 
lights,  according  as  the  schol- 
ars are  at  ivork^  or  moving 
and  exercising.  To  keep  windows  partly  open  seems  an  absolute  neces- 
sity in  many  school-rooms.  In  one-rooined  country  schools,  one  of  the 
first  steps  in  sanitation  is  to  insist  on  the  upper  sashes  being  arranged  so 
as  to  be  lowered.  An  open  window  is  an  evil,  nevertheless,  in  cold 
weather.  The  palliative  measure  to  be  recommended  is  a  strip  of  boaro 
a  few  inches  wide  placed  so  as  to  deflect  the  current  from  under^  the 
lower  sash,  and  make  it  pass  above  the  heads  of  pupils.     This  is  a  decided 


SCHOOL  HYGIENE.  83 

mitigation  of  the  draught.  It  is  very  often  liked  in  rooms  where  the 
ventilation  is  otherv^^ise  bad.  A  tilting  sash  at  the  top  of  a  w^indow  can- 
not safely  be  used  in  winter.  Such  a  sash,  however,  ought  to  be  placed 
over  every  room  door  to  enable  the  occupants  to  share  to  some  extent  in 
the  purer  air  of  the  entries.  There  is  no  question  of  the  good  done  by 
temporary  opening  of  windows  and  doors  for  a  minute  or  two  while 
scholars  are  exercismg.  The  effect  may  be  supposed  to  disappear  in  two 
minutes  or  so  ;  but  when  combined  with  a  short  physical  exercise  in  the 
standing  posture,  its  effect,  both  moral  and  physical,  is  undeniably  good. 
In  a  very  carefully  conducted  school  known  to  the  writer,  this  is  done 
every  hour,  the  period  of  five  minutes  being  allotted  for  that  purpose, 
unless  there  is  a  regular  recess.  At  recess  time,  also,  it  is  the  rule  that 
no  child  shall  remain  in  the  I'ooms,  but  that  all  shall  go  to  the  play-rooms 
under  charge  of  their  teachers,  the  windows  in  the  mean  time  being 
opened  by  scholars  deputed  for  the  task.  These  measures,  well  carried 
out,  greatly  relieve  the  condition  of  a  school  which  has  no  efficient  sys- 
tem of  flue  ventilation. 

The  "  Eureka"  ventilator  is  an  opening  in  the  wall  to  let  in  air  directly. 
It  has  a  valve,  and  the  passage  is  bent  so  as  to  throw  the  air  upwards. 
It  is  a  useful  accessory  in  some  cases  where  a  thorough  ventilation  is  not 
planned  for.  Similar  openings  are  often  found  behind  steam-coils  in 
school-rooms.  Their  utility  is  delusive  ; — they  deliver  a  very  small  quan- 
tity of  air,  and  are  liable  to  be  stopped  up  by  accident,  or  for  the  pur- 
pose of  keeping  out  the  cold. 

Much  has  been  said  of  the  supposed  capacity  of  cast-iron  stoves  to  let 
carbonic  oxide  gas  pass  out  through  their  pores,  thus  contaminating  the 
air  with  a  peculiarly  deadly  poison.  The  present  weight  of  evidence 
does  not  sustain  this  belief. 

IV.    SEWERAGE. 

It  is  difficult  to  trace  any  large  amount  of  disease  in  schools  directly  ta 
offensive  privies  or  sewers.  There  can  be,  however,  do  doubt  that  some 
is  so  caused.  The  school  is  often  supplied  with  water  from  a  contam- 
inated well.  Bad  air  and  stenches  are  not  always  provocative  of  illness, 
but  the  common-sense  of  civilized  races  suspects  them,  and  there  is  no 
doubt  that  they  may  promote  debility,  headache,  loss  of  appetite  and 
digestive  tone,  and  general  depression  of  vitality  ;  while  in  the  minds  of 
some  physicians  there  is  no  doubt  that  dysentery  maybe  caused,  and  per- 
haps typhoid  fever,  and  that  scarlatina  and  diphtheria  may  be  aggravated 
by  exposure  to  foul  air.  Pneumonia,  tonsillitis,  rheumatism,  and  neural- 
gia are  probably  to  be  included. 

Although  drainage,  as  applied  to  school  buildings,  is  governed  by  the 
general  rules  applicable  elsewhere,  it  may  yet  be  desirable  to  note,  in 
passing,  the  chief  of  these  rules.  A  certain  number  of  points  of  more 
special  application  will  be  noticed  afterwards. 

In  all  houses,  whether  used  for  school  purposes  or  not,  the  drain,  soil, 
and  waste  pipes  ought  to  be  of  iron,  visible  and  accessible  throughout 


84  SCHOOL   HYGIENE. 

their  course,  x.  possible  ;  without  angles,  as  straight  as  possible,  and 
never  horizontal.  Soil  and  waste  pipes  are  to  be  carried  up  full  size, 
two  feet  above  the  house  roof,  and  there  guarded  against  the  weather. 
A  trap  is  to  be  provided  for  each  sink,  basin,  urinal,  or  closet,  and  a 
running  trap  for  the  outlet  of  the  drain,  with  an  opening  from  the  drain 
for  ventilation,  just  inside  the  trap.  Safes  are  to  be  connected  with  the 
drain  directly.  Rain-water  leaders  are  not  to  be  used  for  any  other  pur- 
pose, and  vice  versa.  The  best  trap  for  sinks  is,  perhaps,  the  ball  trap. 
Ordinary  S  traps  are  often  shallow,  and  are  rather  more  easily  siphoned 
than  D  traps.  Traps  are  to  be  ventilated  by  i^-inch  pipe  leading  to  the 
general  ventilator '  (/.  e.,  the  continuation  of  the  soil  or  waste  pipe) 
above  all  other  inlets.  If  not  ventilated,  the  omission  must  be  made  upon 
good  authority.  Bell  traps  are  convenient  for  the  floors  of  urinals,  but 
they  are  rather  inefficient  unless  the  seal  is  made  deeper  than  usual. 

In  many  towns  there  is  a  supply  of  aqueduct  water,  but  no  public 
sewer.  In  this  case  the  drain  usually  discharges  into  a  cesspool,  loosely 
built,  which  permits  the  escape  of  fluids  into  the  soil.  This  arrangement 
is  satisfactory  when  there  is  a  good  deal  of  spare  land,  and  when  the  soil 
is  light  and  gravelly.  In  a  clayey  soil  it  may  be  entirely  inadmissible. 
If  the  population  is  even  moderately  compact,  sewers  should  be  provided 
at  once,  under  peril  of  infecting  the  subsoil  air  to  such  an  extent  as  to 
influence  the  air  of  cellars.  City  schools  are  usually  provided  with 
water-closets  proper,  or  with  flush-tanks  or  iron  latrines.  In  country 
schools  the  ordinary  privy  is  almost  universal.  Good  water-closets  are 
doubtless  the  best  arrangement,  so  long  as  they  are  kept  in  order.  No 
kind  yet  invented  is  free  from  the  danger  of  derangement.  A  hopper 
which  gives  a  full  and  quick  discharge  of  water  is  probably  the  best  for 
schools.  The  discharge  may  be  dependent  on  the  movement  of  the  door 
or  seat,  or  may  be  arranged  to  occur  at  once  in  all  the  bowls  at  a  given 
signal. 

The  flush-tank  is  a  long  vault  of  masonry,  over  which  the  seats  are 
built.  It  should  have  a  round  bottom  and  rounded  corners.  At  one  end 
is  a  tap  of  water  ;  at  the  other,  in  the  bottom,  a  plug  to  let  out  the  con- 
tents. The  janitor  should  remove  the  plug,  and  flush  and  swab  the  inte- 
rior at  least  once  a  clay.  With  proper  ventilation  there  need  be  no  of- 
fensive odors.  If  placed  in  a  well  lighted  cellar,  it  will  give  satisfaction  as 
long  as  it  is  carefully  attended  to  ;  but  such  is  human  nature,  that  we  may 
expect  to  find  a  certain  proportion  of  cases  in  which  due  care  is  not  given, 
and  consequently  dissatisfaction  is  felt.  There  is  a  great  difterence  of 
opinion  among  intelligent  heads  of  schools  upon  this  point,  some  being 
unwilling  to  tolerate  these  arrangements  under  the  house-roof,  while 
others  are  strong  iri  support  of  them.  On  the  whole,  it  seems  better,  if 
we  cannot  be  sure  of  the  future  character  of  the  service  rendered,  to  place 
all  of  them  out  of  doors.  A  flush-tank  will  not  freeze  in  the  climate  of 
New  York  city  if  emptied  at  night.  In  colder  places  it  maybe  necessary 
to  empty  not  only  the  tank  (which  in  any  case  should  be  always  done), 
but  also  the  pipes  leading  to  it,  directly  after  school. 


SCHOOL  HYGIENE.  85 

An  unobjectionable  apparatus  consists  of  an  iron  sink  coated  inside 
with  a  firm  glaze,  rising  to  contact  with  the  seats,  and  only  deep  enough 
to  hold  a  few  inches  of  water,  with  a  suitable  space  above.  There  should 
be  no  riser.  The  whole  should  be  above  ground,  in  a  place  moderately 
warmed  ;  the  water  to  be  drawn  off  daily,  and  in  cold  weather  not  re- 
placed till  the  next  day.  For  an  out-of-doors  sink,  if  iron  is  used  it  must 
not  be  supplemented  by  a  wall  of  masonry  built  above  it,  as  the  contrac- 
tion and  expansion  of  the  metal  cause  a  breaking  away  from  the  masonry. 
As  regards  freezing,  the  writer  is  informed  by  the  superintendent  of 
schools  at  Springfield,  Mass.,  that  it  does  not  occur  when  the  water  is 
shut  off  from  the  out-door  sinks  and  drawn  off. 

A  school-house  should  have  one  water-closet  in-doors,  for  the  use  of 
females.  A  building  of  two  or  more  stories  may  properly  have  one  on 
each  story,  in  order  to  save  girls  the  fatigue  of  climbing  stairs  in  cases 
where  the  privilege  is  desired,  and  also  for  the  teachers'  use. 

The  urinal  appears  to  present  a  difficult  problem  ;  but  the  whole  mat- 
ter  lies  in  two  words — non-absorbent  surfaces  and  frequent  cleaning. 
One  of  the  best  forms  is  composed  entirely  of  slabs  of  slate,  forming  a 
wall  five  feet  high,  with  a  gutter  at  its  foot.     The  gutter  is  cut  in  the 
floor-pieces  on  which  the  pupils  stand.     Upright  slabs  divide  the  space, 
in  the  interest  of  decency.     Slate  is  almost  impervious  to  moisture,  and 
is  made  quite  so  by  oiling  with  linseed  oil.     The  apparatus  in  question 
is  usually  furnished  with  a  perforated  water-pipe,  to  keep  the  front  sur- 
face of  the   stone  moistened  with  a  sheet  of  water.     The  idea  is  a  good 
one,  but  requires  such  exactness   of  mechanical  work  that  the  jets  are 
rarely  in  perfect  order.     It  has  the  further  disadvantage  of  seeming  to 
excuse  a  part  of  the  duty  of -scrubbing.    No  portion — side,  base,  or  back — 
should  be  neglected  in  this  respect.    All  these  surfaces  are  liable  to  grow 
foul.     The  amount  of  work  needed  to  give  thorough  cleaning  is  consid- 
erable, but  it  is  the  only  way  to  secure  purity.     The  janitor's  task  ought 
to  be  lightened  by  having  the  whole  floor  of  the  apartment  slope  towards 
the  gutter,  so  that  the  hose  can  be   used  freely.     Some  urinals  have  a 
raised  platform,  in  order  to  define  the  place  to  stand  on.    The  better  way 
would  be  to  have  a  depression,  which  would  equally  define  the  position. 
A  monitor,  in  either  case,  should  stand  by  to  check  irregular  behavior. 

All  complication  of  structure  in  these  departments  should  be  avoided. 
Concealment  of  the  basin  of  a  water-closet  by  wood-work  is  not  desira- 
ble, and  the  wooden  seat  should  be  so  fitted  that  it  can  easily  be  removed 
for  cleaning  or  renewal.  The  urinal  needs  no  trough.  It  should  be 
made  of  materials  which  are  not  porous  :  no  metal  work  is  admissible, 
for  rust  is  sure  to  come,  and  the  animal  matter  of  the  urine  so  saturates 
the  rust  that  it  can  hardly  be  soaked  out.  Paint  soon  scales  off  from 
metal.  Wood  can  be  protected  by  paint  for  a  time,  and  then  be- 
comes soaked  with  urine  unless  repainted.  The  writer  has  seen  marble 
used — a  material  whose  absorbent  powers  may  be  seen  in  the  large  slabs 
used  in  restaurants,  depots,  and  such  places. 

Little  need  be  said  about  the  common  privy  attached  to  most  country 


S6  SCHOOL  HYGIENE. 

schools.  In  many  cases  this  is  the  last  thing-  attended  to.  It  is  practi- 
cally outside  of  the  teacher's  supei"v'ision,  and  one  can  hardly  blame  a 
young  and  modest  woman  for  foiling  to  see  that  her  duty  lies  in  this  direc- 
tion. It  is  generally  a  first-class  nuisance  as  regards  odor,  insupportable 
if  placed  within  a  convenient  distance  ;  but  if  set  off  fifty  feet  or  so,  the. 
exposure  which  the  pupils  undergo  in  cold  or  wet  weather  is  a  serious 
matter.  In  perhaps  one  half  of  the  cases  it  is  out  of  repair.  The  accu- 
mulations go  on  for  a  year  at  a  time.  Finally  the  walls  are  covered  with 
dirty  scrawls  ;  and  very  commonly  the  girls'  closet  is  contiguous  to  the 
boys',  so  that  every  thing  is  heard  through  the  partition. 

The  remedy  for  a  part  of  these  troubles  may  be  found  in  a  more  active 
interest  on  the  part  of  the  school  trustee.  He  can  have  the  place  repaired, 
the  scribbling  effaced  with  a  plane,  and  paint  applied  so  as  to  give  a 
thoroucrhly  neat  look.  He  should  try  to  have  both  the  teacher  and  the 
scholars  cooperate  in  maintaining  a  high  standard  of  neatness,  securing, 
if  possible,  an  occasional  visit  from  the  teacher,  and  making  such  him- 
self, so  as  to  insure  that  no  breakage  or  injury  goes  unnoticed. 

Most  privies  are  too  dark.  Two  closets  in  immediate  contact  do  not 
insure  a  proper  and  modest  degree  of  separation  between  the  sexes  :  in 
such  a  case,  the  bo3's  and  girls  should  have  recess  at  different  times.  If 
thei-e  are  really  two  separate  out-houses,  it  is  well  to  have  them,  and  the 
approaches  to  them,  separated  by  a  sufficient  fence.  Thei-e  ought  to  be 
plank  walks,  or  raised  ways  (paved,  asphalted,  gravelled) ,  to  enable  the 
scholars  to  go  dry-shod.  But  the  plan  which  commends  itself  to  the  writer 
as  by  all  means  the  best  for  country  schools  is  the  use  of  dry  earth  in 
vaults,  emptied  w^eekly,  in  a  shed  close  to  the  school-house,  and  access- 
ible by  a  short,  covered  way.  It  may  be  thought  best  to  retain  the  old 
style  of  privy  for  the  boys,  keeping  it  at  a  distance  from  the  house  as 
before  ;  lout  for  girls  and  little  children  it  is  most  certainly  desirable  to 
have  a  place  which  they  can  reach  without  danger  to  health. 

Not  to  mince  matters,  the  direct  exposure  of  a  sensitive  part  of  the 
body  to  the  gusts  of  a  north-east  storm  is  not  a  thing  to  be  regarded  as  a 
trifle  ;  in  certain  states  of  the  system  it  may  be  highly  dangerous.  And 
both  girls  and  small  children  are  sometimes  led  to  slight  the  calls  of 
nature,  to  their  bodily  harm,  by  fear  of  exposure  to  bad  weather.  The 
plan  here  suggested  is  one  which  may  be  found  illustrated  in  the  repoi^t 
of  the  Connecticut  State  Board  of  Health  for  1883.^  In  that  report  there 
is  given  a  plan  for  a  country  district  school,  which  places  both  privies 
under  the  school  roof,  but  at  opposite  ends  of  the  structure.  Difficulty 
in  keeping  the  boys' place  in  order  (owing  to  the  need  of  a  urinal)  is 
anticipated,  and  there  is  presented,  as  an  alternative,  a  jdUui  which  con- 
tains only  the  girls'  closet,  as  is  here  recommended. 

The  figure  appended  is  taken  from  that  report  (numbered  figure  10 — 
in  the  present  essay,  No.  15).  It  shows  a  single  school-room  with  sep- 
arate entrances  for  the  sexes.  On  the  girls'  side  at  the  rear  is  a  small, 
square  building,  isolated  from  the  main  building  by  an  18-inch  passage- 

1  In  a  paper  by  the  writer  of  this  essay. — Secretary. 


SCHOOL  HYGIENE. 


87 


way  around  It,  but  intended  to  be  sheltered  by  the  same  roof.  The  detail 
of  the  construction  of  such  a  closet  is  very  simple.  It  requires  a  recep- 
tacle, consisting  of  a  brick  trough  about  two  feet  wide,  rounded  at  bot- 
tom and  corners,  and  coated  internally  with  coal  tar  to  prevent  the  ab- 
sorption of  fluids  or  gases.  The  coating  is  continued  over  the  top  of  the 
bricks  and  down  the  front  as  far  as  exposed.  The  bottom  is  an  inverted 
arch  of  masonry,  bedded  in  cement  and  coated  with  the  same,  and  pro- 
jecting slightly  at  the  outer  end  to  facilitate  removal  to  buckets.  Four 
feet  is  a  sufficient  depth.  The  bottom  ought  not  to  be  so  low  that  water 
from  the  surrounding  land  can  run  into  it ;  and  it  is  better  that  it  should 


Fi$.15. 


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be  raised  above  the  ground  level  for  convenience  in  removing  the  con- 
tents. There  should  be  a  bin  for  dry  earth  in  a  sheltered  place  handy 
for  use.  Two  inches  of  this  earth,  finely  powdered,  are  to  be  spread  on 
the  floor  of  the  pit  at  first,  and  a  little  sprinkled  on  daily :  a  complete 
removal  is  made  at  the  end  of  each  week. 

The  present  writer  would  corroborate  the  plan  here  proposed  by  cases 
which  he  has  recently  seen,  in  which  the  earth  removal  system  is  carried 
out  with  entire  success.  An  ordinary  projection  in  the  rear  answers 
every  purpose  ;  the  chamber  ought,  however,  to  be  isolated  by  a  narrow 
passage-way,  furnished  with  screened  windows,  which  should  be  kept 
open.  The  portable  earth-closet  may  be  found  useful,  but  in  reality  it 
possesses  no  advantage  over  this  arrangement. 

The  only  disinfectants  required  for  well  arranged  water-closets  are 
water,  soap,  and  fresh  air.  For  earth-closets,  no  more  than  these  and 
earth  are  needed.  Privies  ought  not  to  become  offensive  :  treatment  with 
earth  should  be  resorted  to,  and  if  that  is  thought  inapplicable  to  deep 
vaults,  then  let  the  vaults  be  shallow  for  the  purpose  of  speedy  removal. 
But  in  cases  of  existing  nuisance,  or  in  epidemics  of  fever,  dysentery,  or 
cholei-a,  it  is  well  to  be  provided  with  a  temporary  remedy  ;  and  for  this 
purpose,  chloride  of  lime,  or  corrosive  sublimate,  as  recommended  by  a 
committee  of  the  American  Public  Health  Association,  may  be  used. 
Chloride  of  lime  has  the  disadvantage  of  a  strong  smell.  Whichever  is 
used  may  be  prepared  by  dissolving  in  soft  water  chloride  of  lime  (of 
the  best  quality)  in  the  proportion  of  a  pound  to  four  gallons,  or  cor- 
rosive sublimate,  a  pound  to  twelve  gallons.  The  latter  solution  is  to  be 
colored  with  permanganate  of  potash  (nine  drachms)  to  prevent  mis- 


88  SCHOOL  HYGIENE. 

takes.     Of  the  former  solution,  use  a  quantity  equal  to  the  supposed  solid 
contents  of  a  vault ;  of  the  latter,  one  fourth  as  much. 

If  used  undissolved,  one  pound  of  chloride  of  lime  corresponds  to  thirty 
pounds  of  the  solids;  one  pound  of  corrosive  sublimate  to  five  hundred 
pounds.  Subsequently,  chloride  of  lime  may  be  freely  sprinkled  over 
the  contents  daily.  A  corrosive  sublimate  solution  may  be  used  for  the 
same  purpose,  four  gallons  a  day,  made  by  the  following  formula  :  Cor- 
rosive sublimate  and  permanganate  of  potash,  of  each  2  drachms 
{\  ounce) ,  dissolved  in  a  gallon  of  soft  water.  This  may  be  kept  in  a 
tub  or  crock,  not  in  a  metal  vessel.  As  a  precaution  in  case  of  an  epi- 
demic, wash  the  interior  of  the  vault  daily  with  this.  If  green  vitriol 
(sulphate  of  iron)  is  used,  take  a  pound  and  a  half  to  a  gallon  of  water, 

V.    HYGIENE    OF    THE    EYE. 

During  the  period  of  school-life,  as  is  now  generally  known,  certain 
affections  of  sight  increase.  It  would  appear  from  the  uniformity  of  the 
results  of  investigations  that  the  increase  is  a  general  rule  ;  and  most  of 
those  who  have  treated  of  the  subject  have  considered  it  due,  in  a  great 
degree,  to  the  effect  of  over-exertion  of  the  eyes  in  school,  more  partic- 
ularly when  the  light  is  bad  and  the  rooms  unwholesome.  It  is  generally 
accepted  as  proved  that  near-sight  is  very  liable  to  be  inherited.  Far- 
sight (old-sight)  is  also  found  in  children,  and,  like  near-sight,  it  increases 
in  frequency  and  degree  as  children  grow  older,  until  somewhere  about 
the  age  of  fifteen  it  begins  to  be  less  frequent,  and  at  the  age  of  twenty, 
among  students,  near-sight  decidedly  preponderates  over  far-sight.  Dr. 
E.  G.  Loring  has  given  diagrams  illusti-ating  this  fact  in  the  case  of  three 
nationalities, — the  German,  the  Russian,  and  the  American.  The  ob- 
serv^ers,  whose  facts  are  taken  for  the  diagrams,  are  Conrad,  who  exam- 
ined 3,036  eyes  of  school-children  in  Konigsberg  ;  Erismann,  who  exam- 
ined 4,358  eyes  of  scholars  in  St.  Petersburg ;  and  Derby  &  Loring,  who 
examined  2,265  eyes  in  New  York  schools.  The  ages  in  all  cases  run 
from  the  youngest  to  the  oldest  pupils,  including  members  of  superior 
schools,  up  to  the  age  of  twenty.  In  the  German  table  the  percentage  of 
near-sighted  eyes  rises  from  11  ^^j  in  the  young  children  to  62^^  in  the 
oldest ;  in  the  Russian,  from  I3x^  to  43  -f-^  per  cent.  ;  and  in  the  Amer- 
ican, from  3^  per  cent,  at  six  to  seven  years  to  26-/^^  per  cent,  in  the 
twenty  to  twenty-first  year. 

There  are  a  good  many  other  similar  series  of  observations,  all  agree- 
ing substantially  with  these,  but  the  German  percentages  are  always  very 
much  higher  than  the  American.  This  is  not  surprising  if  school  work 
has  anything  to  do  with  the  result,  for  German  children  in  all  superior 
schools  (rcal-schulen  and  gymnasia)  are  made  to  do  an  amount  of  work 
which  is  incredible  to  our  school-boys,  and  with  some  results  to  show  in 
the  way  of  intelligence,  too.  German  children  in  America  also  show  a 
decidedly  greater  percentage  of  near-sight  than  American  children, 
owing,  no  doubt,  to  hereditary  influence.     In  a  board-school  in  London, 


SCHOOL  HYGIENE.  89 

Brudenell  Carter  has  lately  found  nearly  10  per  cent,  ot  near-sight  among 
267  children.  These  are  the  facts,  and  to  most  minds  they  seem  to  point 
to  a  tendency  in  national  life  which  is  truly  alarming.  It  is  a  distinct 
drawback  to  a  person's  usefulness  to  have  abnormal  sight ;  to  have  to 
wear  glasses  is  a  serious  drawback  for  many  purposes ;  and  yet  Ger- 
many, which  is  leading  the  world  in  education,  is  far  ahead  in  respect  to 
near-sight,  and  we  seem  to  be  following  her  in  both  points. 

There  are  those,  however  (as  Landolt),  who  lay  the  chief  streso,  as 
regards  causation,  upon  general  conditions  of  health,  ixiaintaining  that 
hardship  and  poor  fare  constitute  one  of  the  chief  causes  of  near-sight. 
It  may  be  so,  and  this  is  not  the  place  to  enter  into  the  argument  satis- 
factorily;  but  if  so,  how  shall  we  apply  the  doctrine  to  the  case  of  Am- 
herst college,  where  Derby's  strictly  accurate  statistics  show  an  increase 
from  44 tV  to  50/0-  per  cent,  during  the  four  years  course  ?  In  Amherst 
the  conditions  of  living  are  as  favorable  as  can  be  found.  Not  onlv  is 
there  no  "hardship  and  poor  fare,"  in  Landolt's  sense,  but  the  young 
men  are  under  a  regime  of  physical  exercise  which  produces  a  distinct 
effect  in  lessening  illness  during  their  residence. 

A  brief  statement  of  the  leading  causes,  not  in  any  presumed  order  of 
frequency,  is  given  here  : 

1 .  Inherited  tendency.  * 

2.  Study  while  the  system  is  in  a  weakened  condition. 

3.  Study  in  a  bad  light. 

4.  Study  in  a  bad  posture. 

5.  Study  while  the  eye  or  brain  is  fatigued  or  congested. 

6.  Study  in  excess  at  the  formative  period  of  life,  when  the  bodily  tis- 
sues easily  assume  a  wrong  bent. 

These  will  probably  cover  the  ground,  so  far  as  relates  to  our  present 
practical  object,  pretty  nearly.  The  writer  ventures  also  to  offer  a  series 
of  practical  remarks  in  the  form  of  rules  at  this  point,  leaving  further 
discussion  till  later. 

RULES    FOR    USING    THE    EYES. 

In  school  work  we  should  require, — 

1.  A  comfortable  temperature,  and  especially  let  the  feet  be  kept 
warm  and  dry. 

2.  Good  ventilation. 

3.  Clothing  at  the  neck  loose.  The  same  as  regards  the  rest  of  the 
body. 

4.  Posture  erect ; — never  read  lying  down  or  stooping. 

5.  Little  study  before  breakfast,  or  directly  after  a  hearty  meal ;  none 
at  all  at  twilight  or  late  at  night. 

6.  Great  caution  about  study  after  recovery  from  fevers. 

7.  Light  abundant,  but  not  dazzling. 

8.  Sun  not  shining  on  the  desk,  or  on  objects  in  front  of  the  scholar. 

9.  Light  coming  from  the  left  hand,  or  left  and  rear  ;  under  some  cir- 
cumstances from  in  front. 


90  SCHOOL  HYGIENE. 

10.  The  book  held  at  right  angles  to  the  line  of  sight,  or  rv&sxXy  so. 

11.  Frequent  rest  by  looking  up. 

13.  Distance  of  book  from  the  eye  about  fifteen  inches. 

As  regards  tlie  causes.  No.  2  refers  especially  to  the  case  of  conva- 
lescents after  measles,  scarlet  fever,  and  other  weakening  fevers.  No.  6 
requires  attention  on  account  of  some  suggestive  remarks  made  by  Dr. 
Loring  in  the  report  referred  to.  He  enlarges  on  the  compai-ative  neg- 
lect of  out-door  life,  and  the  unwholesome  habits  of  eating  and  living 
that  are  found  among  German  children  as  contrasted  with  the  free  play 
and  plenty  of  fresh  air  that  boys  have  in  our  country.  He  also  asserts  a 
belief  that  since  myopia  is  a  disease  of  childhood,  and  rarely  originates 
after  the  age  of  fifteen  or  sixteen,  it  is  desirable  to  give  children  little 
severe  study  until  after  they  have  passed  that  age.  More  concretely,  he 
points  to  the  life  of  an  English  school-boy,  with  his  long  hours  of  foot- 
ball and  cricket,  as  a  better  ideal  than  the  German  plan. 

As  regards  the  rules, — 

Nos.  3  and  4  are  intended  to  prevent  the  occurrence  of  congestion  of 
the  head,  which  is  very  likely  to  injure  the  eye.  A  recumbent  posture  is 
bad  for  another  reason,  viz.,  because  it  places  the  eyeball  in  unaccus- 
tomed positions,  disturbing  the  equilibrium,  and  deranging  the  habitual 
action  of  the  eye  muscles. 

No.  5.  Study  before  breakfast  is  usually  work  done  at  a  disadvantage, 
since  that  period  is  one  at  which  the  strength  of  the  system  is  at  a  low 
point  in  many  people.  If  study  is  done  by  artificial  light,  the  trouble  is 
much  worse. 

No.  7.  Some  persons  are  unduly  sensitive  to  light,  while  others  re- 
quire an  amount  which  is  excessive  for  the  average  person.  Regard  may 
be  had  to  this  fact  in  arranging  the  pupils.  Windows  of  gi'ound  glass, 
if  within  the  range  of  sight,  are  annoying  on  account  of  a  kind  of  daz- 
zling effect ;  if  the  sun  is  upon  them,  they  are  intolerable. 

No.  9.  If  light  comes  from  the  right  hand,  the  pupil's  hand  in  writing 
shades  his  work  annoyingly.  If  from  the  rear,  he  derives  no  direct  ben- 
efit from  it  unless  he  turns  himself  so  as  to  get  rid  of  the  shadow  ;  this 
is  the  position  required  in  writing  by  some  teachers.  A  front  light,  from 
a  window  so  high  that  pupils  practically  are  not  aware  of  its  presence, 
is  good  for  the  purposes  of  writing ;  but  such  a  light  can  hardly  be 
obtained  in  a  class-room  without  annoyance.  Practically,  there  must  be 
no  windows  for  scholars  to  face  while  employing  their  eyesight  upon 
tasks.  This  rule  also  forbids  placing  black-boards  between  windows,  so 
that  scholars  are  obliged  to  face  a  full  light  while  trying  to  read  what  is 
written  on  them.  And  since  the  black-board  is  one  of  the  chief  instru- 
ments of  instruction,  and  a  large  extent  of  it  is  held  desirable,  there  is  an 
advantage  in  restricting  windows  to  one  side  of  a  room,  so  that  the  strip 
of  black-board  may  run  around  three  sides  unbroken,  and  with  every  part 
of  it  in  a  good  light. 

No.  10.  The  desk  lid  slopes  for  the  purpose  named.  It  is  useful  to 
have  light  frames  for  holding  books  in  a  more  upright  position  while  no 


SCHOOL  HYGIENE.  9! 

writing  is  going  on.  Some  desks  are  made  with  a  joint  m  the  middle  of 
the  lid,  giving  the  means  of  obtaining  such  an  inclined  book-holder. 

No.  II.  The  old  rule,  which  punished  all  who  looked  up,  must  be 
given  up.  If  a  pupil  is  restless  and  does  not  apply  himself,  his  case  can 
be  reached  in  various  ways,  but  not  by  a  prohibition  of  this  sort. 

No.  12.  This  distance  need  not  be  an  invariable  one  at  all  times.  If 
generally  observed,  it  will  correct  the  habit  of  stooping.  In  teaching 
penmanship,  very  great  care  is  needed  to  prevent  the  formation  of  bad 
habits  as  regards  attitudes.  The  author  has  seen  a  whole  roomful  of 
children  writing,  with  their  eyes  at  an  average  distance  of  less  than  three 
inches  from  the  paper.  This  exercise  must  not  be  engaged  in  if  cloudy 
weather  makes  the  light  poor.  Ink  should  be  of  a  kind  that  gives  a  per- 
fectly black  mark  when  first  put  on  paper,  not  the  thin,  bluish  fluid 
which  is  black  the  next  day. 

This  is  the  proper  place  to  mention  with  condemnation  the  atlases 
which  are  often  used,  crowded  with  detail  in  small,  delicate  letters  ;  also 
the  small,  "school"  editions  of  large,  standard  dictionaries,  printed  in 
type  which,  though  clear,  is  exceedingly  fine.  Many  school-books  of 
our  day  deserve  much  praise  for  their  clear,  bold  type.  The  use  of  large- 
type  charts  in  teaching  an  entire  class  is  to  be  commended  as  avoiding 
the  necessity  for  a  certain  amount  of  poring  over  books. 

Here  we  may  repeat  what  has  already  been  said  about  very  deep  or 
wide  rooms.     Many  such  are  wholly  unsuited  for  comfort  in  writing. 

If  there  is  a  tendency  to  near-sightedness,  no  pains  should  be  spared  to 
prevent  a  child  from  getting  the  habit  of  holding  his  eyes  too  near  the 
book.  The  distance  of  fifteen  inches  is  not  great ;  but  a  child  must  sit 
up  in  order  to  maintain  it.  This  connects  the  present  topic  with  the 
question  of  school-desks,  of  which  it  will  be  convenient  to  speak  else- 
where. The  maintenance  of  a  true  posture  is  dependent  on  true  propor- 
tions of  desk  and  seat.  When  these  are  obtained,  and  a  child  with  near- 
sighted eyes  is  unable  to  see  clearly  at  the  distance  named,  it  is  the  opin- 
ion of  many  modern  ophthalmologists  that  he  should  be  furnished  with 
glasses  just  sufficiently  strong  for  the  purpose  of  desk  work.  At  the 
same  time  he  may  be  prevented  from  crouching  down  by  the  use  of  an 
apparatus  which  keeps  the  head  at  the  distance  required.  Such  an  ap- 
paratus can  be  made  so  as  to  give  no  annoyance,  and  can  be  kept  per- 
manently screwed  to  the  desk.  Forster,  in  1883,  reported  several  cases 
of  remarkable  improvement  under  this  treatment. 

Although  this  is  not  a  place  for  discussion  of  the  points  involved,  it 
may  be  well  to  mention  that  the  act  of  keeping  the  eyes  close  to  an  object 
is  held  to  involve  a  muscular  effort,  both  in  the  act  of  convei-ging  the  eye- 
balls, and  also  in  the  (unconscious)  act  of  accommodating  the  lens  by 
the  ciliary  muscle,  which  contributes  to  the  increase  of  existing  near- 
sight,  if  it  does  not  originate  it.  The  best  light  for  working  purposes 
comes  from  above,  and  is  nearly  white.     This  suggests  two  points  : 

I.  Windows  throw  light  very  obliquely  on  distant  objects.  It  is  held 
by  the  best  authorities  that  in  general  they  afford  sufficient  light  only 


92  SCHOOL  HYGIENE. 

when  the  distance  from  the  windows  does  not  exceed  once  and  a  half 
times  the  height  of  the  window  itself.  This  restricts  the  depth  of  a  room 
to  about  t\Yenty  feet ;  a  few  more  may  be  allowed  for  the  width  of  an 
aisle.  In  one  of  the  handsomest  high  school  buildings  in  the  country  the 
depth  from  windows  to  opposite  wall  is  forty  feet,  which  cannot  be  recon- 
ciled with  true  principles. 

2.  If  light  from  above  is  to  be  sought,  the  upper  part  of  the  window  is 
most  valuable,  and  should  be  placed  within  six  inches  of  the  ceiling. 
This  greatly  improves  the  illumination  of  the  ceiling,  which  is  itself  a 
very  important  light-giver.  The  lower  part  of  the  windows  is  not  of  so 
much  consequence.  It  is  desirable  that  they  should  not  be  so  low  as  to 
let  in  light  full  upon  the  face  horizontally.  If  the  sill  is  placed  four 
feet  from  the  floor,  no  serious  loss  of  light  occurs.  It  is  usually  stated 
that  if  the  surface  of  window-glass  is  calculated,  it  should  amount  to  from 
-^  to  ^  of  the  floor  surface.  Of  course  this  depends  somewhat  on  the 
locality.  In  order  to  secure  the  required  amount,  one  side  of  the  room 
must  be  made  as  full  of  windows  as  is  consistent  with  the  strength  of  the 
wall.  The  tint  of  the  walls  should  be  a  neutral  shade  of  blue,  quite  light. 
In  general,  paper  is  less  cleanly  than  a  hard  finish. 

Blinds  should  keep  out  the  sun,  and  admit  light  and  air.  They  are 
often  poorly  made  ;  the  rolling  slats  get  out  of  order.  They  should  be 
of  a  light  color ;  natural  wood  color  changes  to  a  dark  brown  in  time, 
but  a  light  green  tint  is  very  pleasant,  and  admits  a  suflSciency  of  light 
when  the  sun  is  shining  on  the  blinds.  Solid  shutters  are  not  suitable. 
Curtains  ought  to  be  provided.  The  kind  which  rolls  from  the  bottom 
is  best,  for  it  cuts  off  the  horizontal  light,  which  is  often  very  annoying 
to  the  teacher  as  well  as  the  scholars,  while  it  leaves  the  vipper  part  of 
the  window  free.  If  it  is  thought  best  to  place  any  windows  in  the  rear 
end  of  the  room,  they  should  be  provided  with  these  shades.  Or  the 
windows  in  that  situation  may  be  placed  at  the  height  of  six  or  eight  feet 
from  the  floor. 

Projecting  "  architectural  features,"  as  cornices  and  pillars,  are  not  to 
be  allowed  to  interfere  with  windows,  or  lessen  the  amount  of  light  enter- 
ing.    Windows  must  be  square  at  the  top. 

VI.    SCHOOL-DESKS    AND    GYMNASTICS 

Some  additional  points  are  here  to  be  given : 

1 .  Support  for  the  feet.  This  needs  special  attention  in  the  case  of 
little  children.     Wooden  foot-rests  ought  to  be  given  when  needed. 

2.  Curves  adapted  to  the  body.  The  seat  ought  to  be  "  curved,"  i.  e., 
hollowed.  The  back  in  American  chairs  is  usually  sloped  so  as  to  fur- 
nish an  easy  support  in  lounging.  Some  such  chairs  are  so  persuasive 
that  one  can  hardly  sit  upright  in  them  :  this  is  a  great  fault,  for  the 
school  ought  to  teach  an  upright  carriage  of  the  body.  The  chairs  used 
in  Germany,  though  the  patterns  vary  greatly,  are  commonly  made  upon 
the  principle  of  supporting  only  the  lower  half  of  the  spine,  usually  by  a 


SCHOOL  HYGIENE.  93 

short,  nearly  upright,  board.  Many  of  our  own  chairs  might  be  greatly 
improved  by  an  approach  to  this  pattern,  the  principle  to  be  followed 
being  this,  that  the  back  of  the  chair  should  fit  the  person  closely  at  the 
lower  part,  where  the  spinal  column  needs  support.  I  have  seen  a  young 
lady  in  a  high  school  suffering  a  good  deal  from  pain  due  to  the  want  of 
support  at  that  point,  which  was  relieved  by  placing  a  cushion  there, 
behind  the  pelvis.  No  seat  that  can  be  devised  is  suitable  for  long  con- 
tinued occupancy  by  healthy  children.  Their  bodily  growth  is  impaired, 
and  deformity  is  caused  by  the  mere  want  of  bodily  activity.  A  cure 
for  the  crooked  spine  is  not,  therefore,  to  be  had  by  carefully  adjusting 
the  size  of  the  desk  to  that  of  the  seat,  and  by  giving  the  appropriate 
curves  to  the  latter,  but  by  developing  the  whole  muscular  system  so  that 
due  support  shall  be  given  by  nature.  The  deformities  which  come 
from  this  source  are  more  frequent  than  is  thought.  Feeble,  pale,  quiet, 
over-dressed,  a  class  of  girls  passes  you,  "filing"  from  room  to  room. 
You  see  one  in  a  dozen  with  rosy  cheeks,  evidently  a  country  girl. 
Their  shoulders  are  all  round,  and  they  have  the  droop  forward  which 
indicates  a  want  of  muscular  vigor  and  deficient  expansion  of  the  chest. 
A  part  of  the  impression  thus  given  may  be  due  to  the  subdued  tone  and 
manner  of  the  school-room.  The  same  girls,  however,  "stay  in  at 
recess  ;"  they  ride  home  in  the  horse-car  ;  their  leisure  is  spent  in  piano 
practice,  and  in  going  to  parties. 

There  is  a  potent  remedy  for  these  evils  in  the  hands  of  school  boards  : 
it  is  the  practice  of  gymnastics.  In  this  single  measure  the  entire  list  of 
evils  called  "school  maladies"  is  attacked  by  giving  increased  force  to 
the  entire  physical  system.  Let  pupils  in  normal  schools  be  first  made 
to  appreciate  the  benefits  of  the  system  by  applying  it  to  them  ;  let  them 
learn  to  discard  sundry  superfluities  of  dress,  by  being  taught  the  com- 
forts of  "  gymnasium  dress;"  let  plain  sense,  under  the  title  of  hygiene, 
be  taught  as  more  important  than  scientific  physiology.  If  this  class  of 
persons  can  be  converted,  a  permanent  benefit  accrues  to  all  their  pupils 
in  future. 

But  to  return  to  the  subject  of  desks  : 

3.  In  classes,  however  well  graded,  great  differences  of  height  are 
noticed.  In  accordance  w^ith  this,  each  class-room  in  a  graded  school 
ought  to  have  at  least  two  sizes  of  desks  ;  three  are  desirable. 

4.  Height  of  the  desk.  When  the  pupil  sits  upright,  and  the  arms 
swing  freely,  the  elbows  will  be  just  below  the  edge  of  the  desk,  and 
when  bent  in  writing,  will  barely  clear  the  edge.  Girls  require  a  desk 
from  one  half  to  three  quarters  of  an  inch  higher. 

5.  The  edge  of  the  desk  must  come  up  to  a  line  just  over  the  edge  of 
the  seat,  or  must  overlap  the  seat  by  an  inch  or  two.  This  keeps  the 
child  from  stooping. 

Nos.  4  and  5  are  of  importance  as  tending  to  prevent  deformity.  Too 
high  a  desk  raises  the  right  or  left  shoulder  unduly.  A  desk  at  a  dis- 
tance from  the  pupil's  seat  compels  him  to  take  a  bad  posture. 

What  remains  to  be  said  of  school  gymnastics  maybe  said  here.     A 


94  SCHOOL  HYGIENE. 

good  deal  may  be  done  with  no  apparatus  at  all  in  the  ordinary  class- 
room. Light  gymnastics,  comprising  movements  of  the  arms,  are  to  be 
practised  dail}-,  more  for  the  benefit  of  the  change  and  for  stimulating 
circulation  than  for  development  of  body.  An  hour  twice  a  week  will 
suffice  for  a  more  thorough  course,  with  a  trained  special  teacher,  in  a 
room  devoted  to  the  purpose.  No  heavy  apparatus  is  recommended, — 
light  wands,  dumb-bells  of  wood,  perhaps  small  clubs.  It  has  been  found 
best  for  classes  exercising  together  in  the  Amherst  college  gymnasium  to 
give  up  the  heavy  gymnastics  altogether  ;  much  more  so  in  schools. 
Then  there  are  the  "  free  exercises,"  including  proper  methods  of  sitting, 
standing,  lying,  walking,  running,  jumping,  as  well  as  exercises  in  con- 
cert, games,  etc. 

"The  aim  of  these  free  exercises  is  to  call  into  action  in  turn  the 
greater  part  of  the  voluntary  muscles  of  the  body ;  and  with  an  intelli- 
gent, earnest  teacher  to  direct  them,  there  is  no  end  to  the  modifications 
and  combinations  that  can  be  made,  calling  for  precision,  and  strict  at- 
tention, and  skill  on  the  part  of  pupils."^ 

A  very  valuable  work  can  be  done  at  once,  with  no  special  apparatus, 
and  with  comparatively  little  training,  by  heads  of  schools  who  have  at 
command  a  spare  room  or  a  hall  with  movable  seats.  The  members  of 
upper  classes  can  be  instructed  by  him  with  perfect  success  in  marching, 
facing,  and  a  variety  of  exercises  of  too  complicated  a  nature  to  be  car- 
ried on  in  the  school-room. 

There  are  two  present  obstacles  to  the  adoption  of  a  complete  system 
of  training, — the  expense,  and  the  want  of  trained  teachers.  The  calling 
of  a  gymnastic  teacher,  in  fact,  is  a  laborious  one.  But  the  matter  is  one 
of  prime  importance,  especially  in  our  city  schools  ;  and  teachers  may 
aid  materially  in  securing  the  adoption  of  a  thorough  system  by  trying 
to  use  the  means  now  in  their  power. 

VII.    AFFECTIONS    OF   THE    NERVOUS    SYSTEM. 

School  life  is  capable  of  doing  much  good,  as  well  as  harm,  to  the 
mental  and  nervous  life  of  scholars.  Over-work,  work  performed  under 
pressure  or  at  bad  seasons  of  the  year,  work  done  in  a  state  of  anxiety, 
are  among  the  causes  of  injury.  The  influence  of  competition  for  prizes 
is  acknowledged  to  be  bad  in  a  great  many  cases. 

"  Double  y    amotions"  ought  to  be  watched  with  care. 

As  regards  over-work,  a  change  in  public  feeling  has  come  about  of 
late,  which  has  largely  led  to  the  abandonment  of  home  study  for  pupils 
under  the  age  of  (about)  twelve  years,  and  has  cut  down  the  hours  of 
attendance  at  school  to  five  in  the  day.  One  innovation  of  modern  origin 
requires  to  be  citicised, — the  use  of  a  single  session,  closing  at  i  or  2 
p.  M.,  instead  of  the  morning  and  afternoon  session.  There  should  be 
one  long  recess  in  such  a  session,  and  arrangements  for  luncheon  may 

1  Dr.  J.  J,  Putnam. 


SCHOOL  HYGIENE.  95 

enter  with  profit  into  the  consideration  of  the  school  authorities,  for  it  is 
unnatural  for  a  growing  youth  or  girl  to  fast  six  hours  on  a  stretch  amidst 
vigorous  exertion  of  mind.  The  fact  that  some  have  no  appetite  for  a 
lunch  constitutes  ground  for  suspecting  that  the  school  life  or  work  is 
responsible  for  the  want  of  appetite. 

It  is  a  serious  grievance  of  teachers  and  scholars  that  the  time  of  year 
when  the  work  is  hardest  is  the  spring  and  early  summer,  the  season 
alike  of  review,  examinations,  diplomas,  promotions,  prizes,  all  of 
which  is  made  more  trying  by  "  spring  sickness  "  and  premature  summer 
heats.  At  the  close  of  a  year's  work  there  should  be  an  approach  to 
relaxation  of  effort.  How  difficult  it  is  to  secure  such  a  relaxation  is 
well  known  to  teachers.  Many  a  teacher  is  ready  to  faint  with  fatigue 
before  the  welcome  rest  comes.  The  children  do  not  now  suffer  so  much, 
their  work  being  rather  irregular  than  severe,  for  the  most  part,  at  those 
times. 

On  a  matter  so  familiar  to  the  public  as  mental  over-work  and  strain 
among  school-children,  not  a  great  deal  need  be  said.  It  is  probable 
that  social  dissipation  does  a  great  deal  more  harm  than  school  work. 
Gii'ls,  of  course,  need  more  watching  than  boys,  for  they  more  readily 
give  up  their  habits  of  out-door  exercise,  and  too  often  have  no  in-door 
work  whatever  to  compensate  for  it.  Even  among  teachers  this  fault  is 
marked.  Their  toil  is  an  anxious  one,  and  they  require  relaxation  as 
much  as  any  profession,  but  they  too  often  fail  to  recognize  the  need. 
The  writer  was  told  by  a  prominent  "kindergarten"  teacher,  who  has 
teachers  under  her  and  instructs  others  in  kindergarten  work,  that  it  is  a 
frequent  fault  among  her  teachers,  as  well  as  her  adult  pupils,  to  suppose 
that  they  could  work  in  the  morning  in  teaching,  attend  a  class  in  the 
afternoon,  and  go  to  parties  in  the  evening,  the  fact  being  that  in  this 
kind  of  work  no  teacher  ought  to  consider  herself  capable  of  any  serious, 
responsible  undertaking  outsldeof  her  kindergarten  ;  and  the  kindergarten 
hours  are  from  nine  to  twelve  o'clock  ! 

Without  doubt  this  is  very  near  the  truth.  Teachers  who  have  five 
hours'  work  a  day  are  to  be  considered  as  having  done  a  day's  work. 
Seldom,  however,  is  the  work  completed  in  that  time,  for  under  the  new 
regime  a  great  deal  of  work  is  written  by  the  children,  and  has  to  be 
looked  over  and  corrected  at  home  by  teachers. 

Among  positive  injuries  to  the  system,  and  symptoms  of  Injury,  the 
following  may  be  named  as  often  due  to  school  fatigue  : 

Debility,  want  of  appetite,  dyspepsia,  sleeplessness,  irritability,  head- 
ache. Other  troubles,  of  less  frequent  occurrence,  are  menstrual  anom- 
alies, irritable  spine,  hysteria,  chorea,  neuralgia.  A  case  of  epilepsy  !s 
known  to  the  writer,  which  recurred  after  five  years  of  health,  in  a  vig- 
orous youth  who  overworked  himself  in  competing  for  a  prize  in  gym- 
nastics. 

Complaints  peculiar  to  females  have  often  been  charged  to  the  injury 
received  in  going  up  and  down  stairs.  Derangement,  including  excess, 
painful  periods,  or  deficiency,  as  well  as  local  displacements,  have  been 


g6  SCHOOL  HYGIENE. 

noticed.  It  is  certain  that  the  existence  of  many  flights  of  stairs  is  com- 
plained of,  and  that  young  women  avoid  rooms  in  the  upper  stories  of 
boarding-schools  in  many  cases.  It  maybe  well  to  give  here  a  summary 
of  the  evidence  collected  by  Geo.  E.  Smith,  m.  d.,  in  1874,  in  respect  to 
a  number  of  such  institutions.  The  replies  amount  to  the  following, 
substantially : 

Answer  No.  i.  The  complaints  named  are  not  usually  prevalent: 
there  are  restrictions  upon  undue  haste  in  going  up  or  down  stairs  : 
should  prefer  to  have  no  dormitories  above  the  second  story. 

2.  They  are  very  frequent,  and  are  due  to  this  cause.     • 

3.  High  buildings  are  bad  if  there  is  carelessness  in  running  up  and 
down,  not  otherwise ;  improper  dress  and  dissipation  are  the  chief 
causes. 

4.  Similar  to  3. 

5.  Rarely  due  to  stairs  ;  due  to  dissipation  :  should  prefer  two-story 
buildings. 

6.  Not  due  to  stairs,  but  to  lacing,  heavy  skirts,  and  over-work. 

7.  Dress,  corsets,  and  stair-climbing  are  far  more  to  blame  than  study. 

8.  Stairs  are  a  great  evil  while  girls  are  dressed  as  they  are  now. 
The  matter  has  been  touched  upon  in  another  division  of  this  essay. 

VIII.    CONTAGIOUS    DISEASE    IN    SCHOOLS. 

The  diseases  intended  by  the  title  are  diphtheria,  scarlet  fever,  measles, 
and  small-pox. 

There  is  little  need  to  enforce  by  argument  the  importance  of  the  sub- 
ject. There  is  a  pretty  general  feeling  that  the  matter  of  complaint  is 
not  an  imaginary  one.  In  the  report  of  the  Massachusetts  State  Board 
of  Health  (ninth)  a  large  number  of  letters  from  physicians  are  cited  or 
referred  to,  all,  with  scarcely  an  exception,  acknowledging  the  danger  of 
contagion  to  be  real.  There  is,  however,  a  mass  of  ignorance  and  blind- 
ness in  the  lower  social  strata  which  cannot  be  expected  to  pay  the  slight- 
est heed  to  ordinary  precautions  for  preventing  contagion  until  forced  to 
do  so.  The  means  for  bringing  such  heedless  persons  to  their  duty  now 
exist  in  many  places  in  the  form  of  local  ordinances  or  school  regula- 
tions.    Such  regulations  should  be  something  like  the  following  : 

1 .  The  existence  of  a  case  of  the  above  named  diseases  should  exclude 
from  school  all  inmates  of  the  house  in  which  it  prevails,  until  compe- 
tent authority  decides  that  it  is  safe  for  them  to  return  to  school. 

2.  Teachers,  school  officers,  or  physicians  should  report  cases  coming 
to  their  knowledge  at  once,  whether  such  cases  are  in  their  own  school 
or  not.  The  child  affected  is  to  be  sent  home  at  once,  and  the  parents 
informed  of  the  law, 

3.  Contagion  being  easily  spread  by  pupils  after  recovery  by  means  of 
clothing  or  fine  particles  of  epidermis,  etc.,  it  is  necessary  to  establish 
rules  for  disinfection,  whether  of  the  premises  and  clothing,  or  of  the 
patient's  body,  the  proper  performance  of  such  disinfection,  and  the  lapse 
of  a  suitable  time,  being  ascertained  upon  good  authority. 


SCHOOL  HYGIENE.  9/ 

4.  Evidence  of  vaccination  should  be  required  of  all  children  entering 
the  public  schools,  and  revaccination  should  be  recommended  to  pupils 
at  a  later  date,  especially  during  epidemics  of  small-pox. 

Contagious  affections  of  the  skin,  and  spasmodic  diseases  (itch,  scald 
head,  ring-worm,  epilepsy,  St.  Vitus's  dance,  habitual  hysteric  attacks), 
are  deserving  of  attention,  as  liable  to  occur  at  any  time  in  a  city  school. 
Teachers  should  have  some  knowledge  of  what  is  to  be  done  in  such 
cases,  and  should  be  authorized  to  complain  to  school  governments. 
The  convulsive  affections  named  are,  some  of  them,  contagious  through 
imitation,  and  must  be  excluded  unless  there  seems  good  reason  for  the 
contrary  course. 

IX.    SANITARY   SUPERVISION. 

As  a  corollary  to  all  that  has  been  said,  we  must  consider  how  the 
facts  can  be  made  operative  in  and  upon  the  schools.  In  many  school 
boards,  one  person — or  a  committee — is  charged  with  matters  pertaining 
to  the  health  of  scholars.  For  most  places  this  plan  is  the  desirable  one. 
In  large  places,  including  cities  of  all  sizes,  a  natural  means  to  this  end 
is  the  appointment  of  one  or  more  persons  charged  with  the  enforcement 
of  regulations  based  on  sanitary  principles.  This  plan  will  soon  be 
tested  thoroughly  ;  the  only  difficulty  (or  rather,  the  only  question)  seems 
to  be  in  relation  to  the  extent  of  the  duties  and  functions  of  such  officers. 

The  cities  of  Elmira,  N.  Y.,  and  Boston,  Mass.,  each  have  an  officer, 
a  physician,  who  acts  as  medical  supervisor.  In  the  latter  place  he  is 
entitled  "Instructor  in  Hygiene,"  the  pectff  iarity  of  the  designation  being 
due  to  certain  technical  difficulties  in  the  local  statutes.  Here  it  may  be 
truly  said  that  the  field  for  one  man's  exertions  being  unlimited,  and  far 
beyond  any  man's  capacity  to  fill,  it  is  open  to  the  incumbent's  discretion 
to  select  the  most  necessary  objects  for  his  first  attention.  At  present 
the  inspection  of  the  buildings  forms  the  leading  object  in  Boston.  In- 
struction in  hygiene  is  also  given  by  means  of  lectures  addressed  to  teach- 
ers.    That  such  an  officer  should  be  a  physician  requires  no  proof. 

How  great  the  opportunity  for  work  may  be  in  certain  cases  is  shown 
by  that  of  the  city  of  Brussels,  which  (for  European  ideas)  presents  a 
model  in  this  respect.  This  city,  with  a  population  of  183,000  and  thirty- 
three  public  schools,  has  a  staff*  of  medical  visitors  sufficient  in  number 
to  make  a  weekly  visit,  with  personal  attention,  to  each  pupil.  In  one 
respect  their  duties  go  beyond  what  is  likely  to  be  thought  advisable  in 
America  at  present, — they  give  medical  treatment  to  a  large  number  of 
pupils  at  school.  The  number  thus  treated  for  the  three  years  i876-'79 
was  446,  732,  1,118,  besides  which,  during  the  same  three  years,  there 
were  2,885  cases  of  dental  treatment.  Among  the  chief  duties  of  such 
an  officer  should  be  those  of  inspection  of  buildings,  and  of  instruction  of 
teachers  in  the  principles  of  hygiene  as  applicable  to  their  charges.  San- 
itary rules  may  be  proposed  by  him,  and  he  will  have  a  great  opportu- 
nity of  rectifying  errors  in  sanitary  administration  due  to  mere  ignorance. 
He  will  not  take  from  members  of  the  school  board  their  right  to  be 


98  SCHOOL  HYGIENE. 

interested,  but  he  can  greatly  increase  the  interest  if  he  knows  how  to 
use  his  knowledge  of  the  subject.  It  need  not  be  said  that  there  are  some 
points  where  the  field  is  already  occupied,  as  the  matter  of  public  vacci- 
nation, and  other  means  for  guarding  against  contagion — matters  usually 
in  the  hands  of  town  or  city  boards  of  health.  Where  these  points  are 
not  thus  arranged,  the  school  inspector  should  have  them  in  charge. 


DISINPECTION  AND  INDIVIDUAL  PROPHYLAXIS  AGAINST 
INPECTIOUS  DISEASES. 


By  GEORGE  M.  STERNBERG,  M.  D., 

Major  and  Surgeon  U.  S.  Army, 

AD  ASTRA   PER  ASPERA. 


Copyright,  1886, 
By  Irving  A.  Watson,  Sec.  American   Public  Health  Association-^ 


All    Rights    Reserved. 


DISINFECTION  AND    INDIVIDUAL   PROPHYLAXIS 

AGAINST  INFECTIOUS  DISEASES. 

INTRODUCTION. 

Definition.  We  are  met  at  the  outset  by  a  difficulty  growing  out  of 
-fche  fact  that  the  word  disinfection^  as  commonly  used,  has  a  very  differ- 
ent signification  from  that  to  which  certain  recent  authors  would  restrict 
it.  Thus,  the  Committee  on  Disinfectants  of  the  American  Public 
Health  Association  defines  a  disinfectant  as  "an  agent  capable  of  destroy- 
ing the  infective  power  of  infectious  material."^  In  the  preliminary  re- 
port of  this  committee  the  reasons  for  restricting  the  meaning  of  the 
word  within  the  limits  justified  by  its  etymology,  and  of  our  knowledge 
of  the  nature  of  "infectious  material,"  are  very  clearly  stated,  as  follows  : 

"The  object  of  disinfection  is  to  prevent  the  extension  of  infectious 
diseases  by  destroying  the  specific  infectious  material  which  gives  rise  to 
them.     This  is  accomplished  by  the  use  of  disinfectants. 

"There  can  be  no  partial  disinfection  of  such  material:  either  its  in- 
fecting power  is  destroyed,  or  it  is  not.  In  the  latter  case  there  is  a  fail- 
ure to  disinfect.  Nor  can  there  be  any  disinfection  in  the  absence  of 
infectious  material.  ****** 

"Popularly,  the  term  disinfection  is  used  in  a  much  broader  sense. 
Any  chemical  agent  which  destroys  or  masks  bad  odors,  or  which  arrests 
putrefactive  decomposition,  is  spoken  of  as  a  disinfectant.  And  in  the 
absence  of  any  infectious  disease  it  is  common  to  speak  of  disinfecting  a 
foul  cesspool,  or  a  bad-smelling  stable,  or  a  privy  vault. 

"This  popular  use  of  the  term  has  led  to  much  misapprehension,  and 
the  agents  which  have  been  found  to  destroy  bad  odors — deodorizers, — 
or  to  arrest  putrefactive  decomposition — antiseptics, — have  been  confi- 
dently recommended  and  extensively  used  for  the  destruction  of  disease 
germs  in  the  excreta  of  patients  with  cholera,  typhoid  fever,  etc. 

"The  injurious  consequences  which  are  likely  to  result  from  such 
misapprehension  and  misuse  of  the  word  disinfectant  will  be  appreciated 
when  it  is  known  that  recent  researches  have  demonstrated  that  many 
of  the  agents  which  have  been  found  useful  as  deodorizers,  or  as  antisep- 
tics, are  entirely  without  value  for  the  destruction  of  disease  germs. 

"  This  is  true,  for  example,  as  regards  the  sulphate  of  iron  or  copperas, 
a  salt  which  has  been  extensively  used  with  the  idea  that  it  is  a  valuable 
disinfectant.  As  a  matter  of  fact,  sulphate  of  Iron  In  saturated  solution 
does  not  destroy  the  vitality  of  disease  germs,  or  the  Infecting  power  of 

'^The  Medical  News,  Phila.,  Jan.  24, 1885,  p.  87. 


102  DISINFECTION. 

material  containing  them.  This  salt  is,  nevertheless,  a  very  valuable 
antiseptic,  and  its  low  price  makes  it  one  of  the  most  available  agents  for 
the  arrest  of  putrefactive  decomposition  in  privy  vaults,  etc. 

"Antiseptic  agents  also  exercise  a  restraining  influence  upon  the  de- 
velopment of  disease  genns,  and  their  use  during  epidemics  is  to  be 
recommended  when  masses  of  organic  material  in  the  vicinity  of  humart 
habitations  cannot  be  completely  destroyed,  or  removed,  or  disinfected. 

"While  an  antiseptic  agent  is  not  necessarily  a  disinfectant,  all  disin- 
fectants are  antiseptics ;  for  putrefactive  decomposition  is  due  to  the 
development  of  '  germs '  of  the  same  class  as  that  to  which  disease  germs 
belong,  and  the  agents  which  destroy  the  latter  also  destroy  the  bacteria 
of  putrefaction,  when  brought  in  contact  with  them  in  sufficient  quantity^ 
or  restrain  their  development  when  present  in  smaller  amounts. 

"A  large  number  of  the  proprietary  'disinfectants'  so  called,  which 
are  in  the  market,  are  simply  deodorizers  or  antiseptics  of  greater  or  less 
value,  and  are  entirely  untrustworthy  for  disinfecting  purposes."^ 

The  offensive  gases  given  off"  from  decomposing  organic  material  are 
no  doubt  injurious  to  health  ;  and  the  same  is  true,  even  to  a  greater  ex- 
tent, of  the  more  complex  products  known  as  ptomaines,  which  are  a 
product  of  the  vital — physiological — processes  attending  the  gro^vth  of 
the  bacteria  of  putrefaction  and  allied  organisms.  It  is  therefore  desira- 
ble that  these  products  should  be  destroyed  ;  and,  as  a  matter  of  fact, 
they  are  neutralized  by  some  of  the  agents  which  we  recognize  as  dis- 
infectants, in  accordance  with  the  strict  definition  of  the  term.  But  they 
are  also  neutralized  by  other  agents — deodorants — which  cannot  be 
relied  upon  for  disinfecting  purposes,  and  by  disinfectants,  properly  so 
called,  in  amounts  inadequate  for  the  accomplishment  of  disinfection. 
Their  foi'mation  may  also  be  prevented  by  the  use  of  antiseptics.  From 
our  point  of  view  the  destruction  of  sulphureted  hydrogen,  of  ammonia, 
or  even  of  the  more  poisonous  ptomaines,  in  a  privy  vault,  is  no  more 
disinfection  than  is  the  chemical  decomposition  of  the  same  substances 
in  a  chemist's  laboratory.  The  same  is  true  as  regards  all  of  the  bad- 
smelling  and  little  known  products  of  decomposition.  None  of  these  are 
"  infectious  matei'ial,"  in  the  sense  in  which  we  use  these  words  ;  that  Is, 
they  do  not,  so  far  as  we  know,  give  rise  directly  to  any  infectious  dis- 
ease. Indirectly  they  are  concerned  in  the  extension  of  the  epidemic 
"  filth  diseases,"  such  as  cholera  and  yellow  fever,  and  of  the  fatal  en- 
demic "filth  diseases,"  such  as  typhoid  fever  and  diphtheria,  which  in 
the  long  run  claim  more  victims  than  do  the  pestilential  maladies  first 
named.  This  because  persons  exposed  to  the  foul  emanations  from  sew- 
ers, privy  vaults,  and  other  receptacles  of  filth,  have  their  vital  resisting- 
power  lowered  by  the  continued  respiration  of  an  atmosphere  contam- 
inated with  these  poisonous  gases,  and  are  liable  to  become  the  victims 
of  any  infectious  disease  to  which  they  may  be  exposed.  Moreover,  the 
accumulations  of  filth  which  give  off' these  offensive  gases  furnish  pabu- 

^Tke  Medical  News,  April  i8,  p.  425. 


DISINFECTION.  IO3 

lum  upon  which  certain  disease  germs  thrive  ;  and  it  may  happen  that 
the  bad  smelling  air  carries  something  worse  than  the  poisonous  gas 
which  makes  its  presence  known  by  offending  the  sense  of  smell.  It 
may  waft  to  our  nostrils  infectious  particles  which  are  beyond  recogni- 
tion by  any  sense,  unless  it  be  the  sense  of  sight  with  the  aid  of  a  good 
microscope. 

We  desire,  moi-eover,  to  have  it  fully  understood  that  in  restricting 
the  meaning  of  the  term  disinfection  within  the  limits  given  by  the  defi- 
nition of  the  Committee  on  Disinfectants  of  the  American  Public  Health 
Association,  we  do  not  wish  to  limit  the  practice  of  "  disinfection,"  in 
the  popular  sense  of  the  word. 

It  is  but  fair  to  say,  also,  that  this  popular  usage  is  supported  by  good 
authority,  and  until  quite  recently  has  been  the  common  acceptation  of 
the  term  among  physicians  and  chemists.  Indeed,  it  is  but  a  short  time 
since  the  nose  test  was  the  only  test  of  "  disinfection  "  recognized  by 
many  intelligent  persons. 

Littre,  in  his  Dictionary  of  the  French  Language,  defines  disinfectants 
as  "  substances  which  destroy,  chemically,  bad  odors." 

Vallin,  the  author  of  the  best  modern  treatise  upon  "  Disinfection  and 
Disinfectants,"  says, — 

"From  a  scientific  point  of  view  there  is  perhaps  an  impropriety  in 
introducing  into  the  idea  of  disinfection  the  suppression  of  odors  which 
offend  the  sense  of  smell.  The  bad  odor  is  not  injurious  in  itself;  it  is 
an  epiphenomenon,  which  does  not  necessarily  give  the  measure  of  the 
hurtful  properties  of  the  air,  or  of  any  substance  whatever.  The  public, 
unacquainted  with  medicine,  has  an  unfortunate  tendency  to  judge  of 
insalubrity  by  the  bad  odor :  the  absence  of  this  gives  to  it  a  deceitful 
security :  when  they  are  masked  by  any  device,  it  [the  public]  believes 
that  all  danger  has  been  removed.  Nevertheless  it  is  necessary  to 
avoid  violating  the  ordinary  sense  of  words?-  An  atmosphere  which 
does  not  in  the  least  offend  the  sense  of  smell  may  certainly  be  insalubri- 
ous, and  engender  the  gravest  maladies  ;  but  the  fetid  or  disagreeable 
odors  may  reveal  the  presence  of  injurious  principles,  of  toxic  gases,  or 
of  organic  matter  in  decomposition.  We  should  not  too  much  diminish 
the  importance  of  these  offensive  odors  in  the  eyes  of  the  public :  every- 
thing which  smells  badly  is  to  be  suspected."^ 

We  agree  with  Prof.  Vallin,  that  the  bad  odors  should  arouse  suspi- 
cion, and  lead  to  the  use  of  deodorants,  or  of  antiseptics,  or  of  disinfect- 
ants, if  required  ;  but  let  us  not  leave  the  public  to  suppose  that  when  the 
bad  odors  have  been  neutralized,  the  offensive  material  has  been  disinfect- 
ed. Let  us  rather  instruct  the  public  that  to  deodorize  and  to  disinfect 
are  not  one  and  the  same  thing,  and  that  deodorant  and  disinfectant  are 
not  synonymous  terms.  For  our  part  we  prefer  to  "violate  the  ordi- 
nary sense"  of  the  word,  and  to  restrict  its  signification  within  such  limits 

^  Italics  by  present  writer. 
=  Op.  Cit.,  p.  2. 


104  DISINFECTION. 

as  will  prevent  confusion,  and,  what  is  far  worse,  a  reliance  upon  ineffi- 
cient methods  for  the  destruction  of  infectious  material. 

In  the  present  essay  we  shall  use  the  words  disinfection  and  disinfect- 
ant, in  accordance  with  the  definition  of  the  committee  on  disinfectants 
already  given.  But,  inasmuch  as  this  is  intended  to  be  a  practical  treatise 
for  popular  use,  we  shall  also  give,  in  the  proper  place,  directions  for  the 
use  of  deodorants  and  of  antiseptics,  so  that  "'disinfection,"  in  the  broad 
sense  in  which  the  word  is  commonly  used,  may  be  fully  considered. 

Tests  of  Disinfection.  What  means  have  we  of  proving  that  the 
infective  power  of  infectious  material  has  been  destroyed .'' 

Evidence  of  disinfection  may  be  obtained  (a)  from  the  practical  exper- 
iments— experience — of  those  engaged  in  sanitary  work ;  (b)  by  inocu- 
lation experiments  upon  susceptible  animals  ;  (c)  by  experiments  made 
directly  upon  known  disease  germs. 

(a)  It  is  a  matter  of  common  experience,  that  when  a  room  has  been 
occupied  by  a  patient  with  an  infectious  disease,  such  as  small-pox,  scar- 
let fever,  or  diphtheria,  susceptible  persons  are  liable  to  contract  the  dis- 
ease weeks  or  even  months  after  the  patient  has  been  removed  from  it, 
unless  in  the  mean  time  it  has  been  disinfected.  If  a  second  case  does 
occur  from  exposure  in  such  a  room,  it  is  evident  that  it  has  not  been 
disinfected.  But  the  non-occurrence  of  subsequent  cases  cannot  always 
be  taken  as  evidence  that  the  means  of  disinfection  resorted  to  were 
efficient.  Negative  evidence  should  be  received  with  great  caution.  In 
the  first  place,  the  question  as  to  whether  susceptible  individuals  have 
been  fairly  exposed  in  the  disinfected  room  must  be  considered.  Then  it 
must  be  remembered  that  susceptible  persons  do  not  always  contract  a 
disease,  even  when  they  are  exposed  in  a  locality  known  to  be  infected. 
A  further  difficulty  in  estimating  the  value  of  evidence  obtained  in  prac- 
tice arises  from  the  fact,  that,  in  connection  with  the  special  means  of 
disinfection  resorted  to,  such  as  fumigation,  hanging  up  cloths  saturated 
with  a  disinfecting  solution,  etc.,  it  is  customary  to  resort  to  additional 
precautionary  measures,  such  as  washing  surfaces  with  soap  and  hot 
water,  white-washing  plastered  walls,  and  free  ventilation.  It  is  appar- 
ent that  under  these  circumstances  it  would  be  unsafe  to  accept  the  fact, 
that  no  other  cases  occurred  in  a  room  treated  in  this  way,  as  evidence 
that  the  particular  disinfectant  used  is  efficient  for  the  destruction  of  the 
infectious  agent  of  the  disease  in  question.  The  fond  mother  who  at- 
taches a  charm  to  her  child's  neck  to  protect  it  from  evil,  also  takes  the 
precaution  of  guarding  it  from  contact  with  other  children  who  are  sick 
with  any  infectious  disease.  If  her  child  fortunately  grows  to  manhood 
or  womanhood  without  having  suffered  an  attack  of  scarlet  fever  or  diph- 
theria, she  may  imagine  that  her  charm  has  protected  it,  but  the  evidence 
upon  which  her  faith  is  founded  is  not  of  a  nature  to  convince  those 
who  are  familiar  with  scientific  methods  of  demonstration.  "Well  edu- 
cated" persons  are  often  ready  to  testify  in  favor  of  methods  of  disinfec- 
tion, or  of  treatment,  upon  evidence  which,  from  a  scientific  point  of 
view,  has  no  more  value  than  that  which  the  fond  mother  in  question  has 


DISINFECTION.  IO5 

to  offer  in  favor  of  the  little  bag  containing  camphor  or  assafoetida,  or 
some  other  charm  of  equal  value,  which  she  has  attached  to  her  child's 
neck  to  keep  it  from  catching  scarlet  fever  or  diphtheria  at  school.  On 
a  par  with  these  charms,  so  far  as  disinfection  is  concerned,  we  may 
place  the  saucer  of  chloride  of  lime,  which  it  was  formerly  the  fashion  to 
place  under  the  bed  of  a  patient  sick  with  an  infectious  disease,  the  rag 
saturated  with  carbolic  acid,  or  chloride  of  zinc,  suspended  in  the  sick- 
room, and  even  the  fumigations  with  burning  sulphur,  as  sometimes 
practised  by  those  who  are  unfamiliar  with  the  evidence  as  to  the  exact 
value  of  this  agent,  and  the  conditions  necessary  to  ensure  successful  dis- 
infection with  it. 

Chloride  of  lime,  sulphurous  acid  gas,  and  carbolic  acid  are  among  our 
most  useful  disinfecting  agents,  but  disease  germs  are  not  to  be  charmed 
away  by  them  any  more  than  by  a  little  bag  of  camphor. 

Having  pointed  out  the  fact  that  negative  evidence,  in  a  restricted  field 
of  observation,  must  be  accepted  with  great  caution  in  estimating  the 
value  of  disinfectants,  we  hasten  to  say  that  the  combined  experience  of 
sanitarians,  derived  from  practical  efforts  to  restrict  the  extension  of  in- 
fectious diseases,  is  of  the  greatest  value,  and  that  this  experience  is  to  a 
great  extent  in  accord  with  the  results  of  exact  experiments  made  in  the 
laboratory. 

(b)  Inoculation  experiments  upon  susceptible  animals,  made  directly 
with  infectious  material  which  has  been  subjected  to  the  action  of  a  disin- 
fectant, have  been  made  by  numerous  observers.  The  proof  of  disinfec- 
tion in  this  case  is  failure  to  produce  the  characteristic  symptoms  which 
result  from  inoculation  with  similar  material  not  disinfected.  Thus, 
Davaine  found  that  the  blood  of  an  animal  just  dead  from  the  disease 
known  by  English  writers  as  anthrax  or  splenic  fever  (Fr.  Charbon)^ 
inoculated  into  a  healthy  rabbit  or  Guinea-pig,  in  the  smallest  quantity, 
infallibly  produces  death  within  two  or  three  days  ;  and  the  blood  of 
these  animals  will  again  infect  and  cause  the  death  of  others,  and  so  on 
indefinitely.  This  anthrax  blood  therefore  was  infectious  material,  which 
could  be  utilized  for  experiments  relating  to  the  comparative  value  of 
disinfectants.  Davaine  made  ixiany  such  experiments,  not  only  with  the 
blood  of  anthrax,  but  also  with  that  of  a  fatal  form  of  septicemia  in  rab- 
bits, which  is  known  by  his  name.  Other  investigators  have  followed 
up  these  experiments  upon  infectious  material  of  the  same  kind,  and  also 
upon  material  from  other  sources — e.  g. ,  the  infectious  material  of  glan- 
ders, of  tuberculosis,  of  symptomatic  anthrax,  of  fowl  cholera,  of  swine 
.plague,  etc. 

It  has  been  proved  that  the  infectious  agent  in  all  of  the  diseases  men- 
tioned is  a  living  germ,  and  that  disinfection  consists  in  destroying  the 
vitality  of  this  germ.  But  in  experiments  made  with  blood  or  other 
material  obtained  directly  from  diseased  animals,  the  results  would  be 
just  as  definite  and  satisfactory  if  we  were  still  ignorant  as  to  the  exact 
nature  of  the  infecting  agent.  The  test  shows  the  destruction  of  infect- 
ing power  without  any  reference   to  the   cause  of  the  sjDecial  virulence, 


I06  DISINFECTION. 

which  is  demonstrated  to  be  neutralized  by  certain  chemical  agents  in  a 
given  amount.  All  of  the  experiments  made  with  the  above  mentioned 
kinds  of  virus  have  been  made  upon  the  lower  animals  ;  but  there  is  one 
kind  of  material  which  it  is  justifiable  to  use  upon  man  himself,  and  with 
which  numerous  experiments  of  a  very  satisfactory  character  have  been 
made.  This  material  is  vaccine  virus.  Fresh  vaccine,  when  inoculated 
into  the  arm  of  an  unvaccinated  person,  gives  rise  to  a'very  characteristic 
result, — the  vaccine  vescicle.  The  inference  seems  justified  that  any 
agent  which  will  neutralize  the  specific  infecting  power  of  this  material 
will  also  neutralize  the  small- pox  virus.  Thus  far  it  has  not  been  defi- 
nitely proved  that  the  infective  agent  in  vaccine  virus  is  a  living  germ  ; 
but  the  numerous  experiments  made  have  shown  that  the  chemical  agents, 
which  have  the  power  of  destroying  the  various  kinds  of  infectious  mate- 
rial heretofore  mentioned,  have  also  the  power,  in  about  the  same 
amounts,  of  neutralizing  vaccine  virus,  as  shown  by  its  failure  to  pro- 
duce any  result  when  inoculated  into  an  unvaccinated  person.  In  these 
experiments  the  more  careful  investigators  have  taken  the  precaution  of 
vaccinating  the  same  person  with  disinfected  and  with  non-disinfected 
virus  from  the  same  source.  A  successful  vaccination  with  the  non-dis- 
infected virus  shows  that  the  individual  is  susceptible,  and  the  material 
good :  failure  to  produce  any  result  is  evidence  that  the  potency  of  the 
disinfected  virus  has  been  destroyed  by  the  chemical  agent  to  which  it 
was  exposed. 

(c)  As  already  stated,  it  has  been  demonstrated  that  the  infectious 
diseases  of  the  lower  animals,  which  have  furnished  the  material  for  ex- 
periments upon  disinfectants  by  the  method  of  inoculation,  are  "germ 
diseases,"  and  that  the  infectious  agent  is  in  each  case  a  living  micro- 
organism, belonging  to  the  class  known  under  the  general  name  oi  Bac- 
teria. The  bacteria  are  vegetable  organisms,  which,  by  reason  of  their 
minute  size  and  simple  organization,  must  be  placed  at  the  very  foot  of 
the  scale  of  living  things.  But  they  make  up  in  number  and  in  rapidity 
of  development  for  their  minute  size  ;  and  there  is  good  reason  for  believ- 
ing that  the  infectious  diseases  of  man  are  also  caused  by  pathogenic — 
disease-producing — organisms  of  the  same  class.  Indeed,  this  has  already 
been  proved  for  some  of  these  diseases,  and  the  evidence  as  regards  sev- 
eral others  is  so  convincing  as  to  leave  very  little  room  for  doubt. 

Many  of  these  disease  germs  are  now  known  to  us,  not  only  by  mi- 
croscopic examination  of  the  blood  and  tissue's  of  infected  animals,  but 
also  by  "  culture  experiments.''  That  is,  we  are  able  to  cultivate  them 
artificially  in  suitable  media,  and  to  study  their  mode  of  development, 
etc.,  in  the  laboratory,  quite  independently  of  the  animals  from  which 
our  "pure  cultures"  were  obtained  in  the  first  instance.  The  culture 
fluids  used  are  prepared  from  the  flesh  of  various  animals ;  and  when  to 
one  of  these  a  certain  quantity  of  gelatine  is  added,  we  have  a  "  solid 
culture  medium,"  upon  the  surface  of  which  some  of  these  germs  will 
grow  most  luxuriantly.  To  start  such  a  "  culture,"  it  is  only  necessary' 
to  transfer,  with  proper  precautions,  a  minute  quantity  of  the  infectious 


DISINFECTION.  IO7 

material  to  the  surface  of  our  culture  medium,  or  into  a  fluid  which  has 
been  found  to  be  suitable  for  the  growth  of  the  particular  organism  which 
we  desire  to  cultivate.  A  second  culture  is  in  the  same  way  started  from 
the  first,  and  so  on  indefinitely. 

Now  it  is  evident  that  these  "  pure  cultures"  furnish  us  a  ready  means 
for  testing  the  power  of  various  chemical  agents  to  destroy  the  vitality  of 
known  disease  germs,  as  shown  by  their  failure  to  grow  in  a  suitable 
culture  medium  after  exposure  for  a  given  time  to  a  given  percentage  of 
the  disinfectant.  Very  many  experiments  of  this  nature  have  been  made 
during  the  past  three  or  four  years.  The  reader  who  desires  fuller 
details  as  to  the  method  of  conducting  such  experiments,  and  of  the 
results  obtained,  is  referred  to  the  preliminary  reports  of  the  committee 
on  disinfectants,  of  the  American  Public  Health  Association,  published 
during  the  current  year  (1885)  in  the  Medical  News ^  Philadelphia,  and 
which  will,  doubtless,  also  be  published  in  full  in  the  next  annual  volume 
of  the  association.  We  may  say  here,  that  the  experimental  data  on  rec- 
ord indicate  that  those  agents  which  are  efficient  for  the  destruction 
of  any  one  of  the  pathogenic  organisms  upon  which  experiments  have 
been  made,  or  of  harmless  species  of  the  same  class, — e.  g..,  the  bacteria 
of  putrefaction, — are  efficient  for  the  destruction  of  all,  in  the  absence  of 
spores.  There  is,  it  is  true,  within  certain  limits,  a  difference  in  the 
resisting  power  of  different  organisms  of  this  class  to  chemical  agents. 
This  is  not,  however,  sufficiently  marked  to  prevent  the  general  state- 
ment that  a  disinfectaftt  for  one  is  a  disinfectant  for  all.,  in  the  ab- 
sence of  spores. 

The  last  clause  of  the  above  statement  calls  for  an  explanation,  and 
certain  details  with  reference  to  the  mode  of  reproduction  of  disease 
germs.  All  of  the  bacteria  multiply  by  binary  division  ;  that  is,  one 
individual  divides  into  two,  and  each  member  of  the  pair  again  into  two, 
and  so  on.  The  spherical  bacteria,  known  as  micrococci^  multiply  only 
in  this  way,  but  the  rod-shaped  bacteria,  or  bacilli.,  also  form  spores. 
These  spores  correspond  with  the  seeds  of  higher  plants.  They  are 
highly  refractive,  oval  or  spherical  bodies,  which,  under  certain  circum- 
stances, make  their  appearance  in  the  interior  of  the  rods,  which  cease  to 
multiply  by  binary  division  when  spore  formation  has  taken  place.  The 
point  of  special  interest  with  reference  to  these  spores  is,  that  they  have 
a  resisting  power  to  heat,  and  to  the  action  of  chemical  disinfectants,  far 
beyond  that  which  is  possessed  by  micrococci,  or  by  bacilli  without 
spores.  The  difference  may  be  compared  to  the  difference  between  a 
tender  plant  and  its  seeds  to  deleterious  influences,  such  as  extremes  of 
heat  and  cold.  Thus  the  spores  of  certain  species  of  bacilli  withstand  a 
boiling  temperature  for  several  hours,  while  a  temperature  of  150°  Fahr. 
quickly  kills  most  bacteria  in  the  absence  of  spores.  A  similar  differ- 
ence is  shown  as  regards  the  action  of  chemical  agents.  Certain  agents, — 
e.  g.^  sulphurous  acid  gas  and  carbolic  acid, — which  are  extensively  used 
as  disinfectants,  have  been  proved  by  exact  experiments  to  be  quite  im- 
potent for  the  destruction  of  spores.     This  being  the  case,  it  is  advisable, 


I08  DISINFECTION. 

in  practical  disinfection,  always  to  use  an  agent  which  has  the  power  of 
destroying  spores,  in  those  cases  in  which  the  exact  nature  of  the  disease 
germ  has  not  been  demonstrated.  The  cholera  germ  of  Koch  does  not 
form  spores  ;  and  there  is  good  reason  to  believe  that  the  same  is  true  as 
regards  the  germs  of  yellow  fever,  of  scarlet  fever,  and  of  small-pox, 
which  have  not  yet  been  demonstrated.  This  inference  is  based  upon 
evidence  obtained  in  the  practical  use  of  disinfectants,  and  upon  certain 
facts  relating  to  the  propagation  of  these  diseases. 

A  second  general  statement,  which  is  justified  by  the  experimental  evi- 
dence on  record,  is,  that  agents  vjJiich  kill  bacteria  in  a  certain  amount^ 
■prevent  their  multiplication  in  culture  fluids^  when  present  in  quan- 
tities considerably  less  than  are  required  to  completely  destroy  vitality. 
An  agent,  therefore,  which,  in  a  certain  proportion  and  in  a  given 
time,  acts  as  a  "  germicide"  in  a  smaller  quantity,  may  act  as  an  anti- 
septic^ i.  e.,  may  prevent  putrefactive  decomposition  by  restraining  the 
development  of  the  bacteria  of  putrefaction.  Antiseptics  also  prevent  or 
retard  the  development  of  pathogenic  bacteria.  It  follows  from  this  that 
germicides  are  also  antiseptics  ;  but  the  reverse  of  this  proposition  is  not 
true  as  a  general  statement,  for  all  antiseptics  are  not  germicides.  Thus 
alcohol,  common  salt,  sulphate  of  iron,  and  many  other  substances  which 
are  extensively  used  as  antiseptics,  have  scarcely  any  germicide  power, 
even  in  concentrated  solutions,  and  consequently  would  be  entirely  unre- 
liable as  disinfectants. 

Practically,  antiseptics  may  accomplish  the  same  result  in  the  long  run 
as  we  obtain  in  a  short  time  by  the  use  of  disinfectants.  If,  for  example, 
we  prevent  the  development  of  the  germs  of  cholera,  or  of  typhoid  fever, 
in  an  infected  privy  vault,  by  the  continued  use  of  antiseptics,  these  germs 
will  in  time  lose  their  ability  to  grow,  when  introduced  into  a  suitable 
culture  medium.  But  in  the  meantime  there  is  always  the  possibility 
that  some  of  them  may  escape,  with  the  fluid  contents  of  the  vault,  into 
the  surrounding  soil,  and  contaminate  some  well  or  stream  from  which 
drinking-water  is  obtained.  For  this  reason  privy  vaults,  cesspools,  and 
sewers  should  never  be  allowed  to  become  infected.  All  infectious  ma- 
terial, such  as  the  dejections  of  patients  with  cholera  or  typhoid  fever, 
should  be  destroyed  at  its  source,  in  the  sick-room  ;  or,  if  it  is  ascertained 
that  such  material  has  been  thrown  into  a  privy  vault,  the  entire  contents 
of  the  vault  should  be  promptly  disinfected.  The  same  rule  applies  to 
infectious  material  thrown  upon  the  ground,  or  wherever  it  may  be. 
Finally,  we  desire  to  emphasize  the  following  propositions  : 
Disinfection  consists  in  extinguishing  the  spark,  killing  the  germ, 
which  may  light  up  an  epidemic  in  the  presence  of  a  supply  of  combus- 
tible material — filth. 

The  oh]cct  o^ general  sanitary  police  is  to  remove  this  combustible 
material  out  of  the  way,  so  that  no  harm  may  result  even  if  the  spark  be 
introduced. 

Antiseptics  and  deodorants  arc  useful  when  it  is  impracticable  to 
remove  ofiensive  organic  material  from  the  vicinity  of  human  habitations, 
but  they  are  a  poor  substitute  for  cleanliness. 


DISINFECTION.  IO9 

PART  FIRST. 

DISINFECTION. 

It  will  be  our  aim  in  the  present  chapter  to  give  reliable,  practical  di- 
rections with  reference  to  the  use  of  disinfectants,  and  the  best  methods 
of  disinfection.  Keeping  this  object  in  view,  we  shall  recommend  for 
disinfecting  purposes  only  those  agents  named  in  the  following  list : 

Group  I. 

Disinfectants  which  have  the  power  of  destroying  spores  : 

1.  Fire. 

2.  Steam  under  pressure  (25  lbs.). 

3.  Boiling  water. 

4.  Chloride  of  lime  (in  solution)  . 

5.  Liquor  soda  chlorinatae. 

6.  Mercuric  chloride  (in  solution) . 

Group  2. 

Disinfectants  which  are  effective  in  the  absence  of  spores  : 

7.  Dry  heat  (230''  Fahr.  for  two  hours). 

8.  Sulphur  dioxide. 

9.  Carbolic  acid. 

10.  Sulphate  of  copper  (in  solution; 

11.  Chloride  of  zinc  (in  solution). 

Note.  In  the  present  state  of  knowledge,  a  division  of  disinfecting  agents  into  two  groups  be- 
comes necessary,  unless  we  would  entirely  dispense  with  the  use  of  those  agents  named  in  our  sec- 
ond group,  which  cannot  be  relied  upon  for  the  destruction  of  spores,  and  consequently  cannot  be 
recommended  for  the  destruction  of  all  kinds  of  infectious  material.  As  this  group  includes  several 
agents  which  are  extensively  used  for  disinfecting  purposes,  and  which  we  believe  to  possess  great 
practical  value,  we  have  considered  it  necessary  to  make  this  distinction.  The  present  state  of 
science,  however,  does  not  enable  us  to  classify  all  infectious  diseases  in  the  same  way,  and  in  case 
of  doubt  it  will  always  be  advisable  to  use  those  agents  included  in  Group  i.  But  in  the  absence  of 
a  precise  knowledge  of  the  nature  of  the  germ,  we  may  in  certain  cases  be  governed  by  the  practical 
experience  of  sanitarians,  and  by  experiments  which  have  been  made  directly  upon  infectious  ma- 
terial, e,  g.,  on  vaccine  virus.  In  our  recommendations  we  have  taken  account  of  this  kind  of  evi- 
dence, as  well  as  of  laboratory  experiments,  in  which  known  disease  germs  or  harmless  organisms  of 
the  same  class  have  served  as  the  test  of  disinfecting  power. 

We  shall  first  give  a  brief  account  of  the  conditions  of  successful  disin- 
fection with  these  agents,  as  established  by  experimental  data,  and  after- 
ward detailed  directions  for  their  employment  under  the  various  circum- 
stances in  which  disinfection  is  required. 

I.  Fire.  It  is  hardly  necessary  to  say  that  burning  of  infectious  ma- 
terial, infected  clothing,  etc.,  is  an  effectual  method  of  disposing  of  it. 
This  method  of  disinfection  is  always  to  be  recommended,  when  practi- 
cable or  consistent  with  a  due  regard  for  economy  and  the  rights  of 
individuals.  As  a  rule,  articles  of  little  value,  w^hich  have  been  soiled 
with  infectious  material,  had  better  be  burned  ;  and  this  is  especially  true 
of  old   clothing  and  bedding.     But  we   have  other  efficient  methods  of 


1 10  DISINFECTION. 

disinfection,  which  make  it  unnecessary  to  sacrifice  articles  of  value  except 
under  unusual  circumstances. 

2.  Steam  under  Pressure.  The  disinfecting  power  of  steam  given  off 
from  boiling  water  in  an  open  vessel  does  not  differ  from  that  of  the 
water  itself,  but  confined  steam  has  a  temperature  corresponding  with 
the  pressure  as  indicated  by  a  steam  gauge.  At  twenty  pounds  pressure 
the  temperature  is  about  230°  Fahr.  (105°  C.)  ;  at  twenty-five  pounds  it 
is  about  240°  Fahr.  ;  at  thirty  pounds  it  is  250°  Fahr.  Moist  heat  at  the 
lowest  temperature  named  destroys  the  most  resistant  spores  in  twenty 
minutes,  while  a  temperature  of  240°  Fahr.  is  effective  almost  immedi- 
ately.^ 

3.  Boiling.  In  the  absence  of  spores,  bacteria  are  quickly  killed  at  a 
temperature  considerably  below  the  boiling  point  of  water,  and  it  is  safe 
to  say  that  boiling  for  half  an  hour  will  destroy  all  known  disease  germs, 
including  the  spores  of  anthrax,  which  have  less  resisting  power  than  the 
spores  of  certain  harmless  and  widely  distributed  bacilli,  which  have 
been  found  to  resist  boiling  for  several  hours. 

4.  Chloride  of  Lime  (chlorinated  lime,  bleaching  powder).  This  is 
one  of  the  cheapest  and  most  efficient  of  disinfectants.  It  should  be 
packed  in  air-tight  and  moisture-proof  receptacles, — glass  is  preferable, — 
and  should  contain  at  least  25  per  cent,  of  available  chlorine.'^  It  should 
be  used  in  solution,  which  had  better  be  made  as  required.  An  insoluble 
residue  will  be  left,  which  may  be  removed  by  filtration  or  decantation. 
This,  however,  is  not  at  all  necessary.  Chlorinated  lime  owes  its  disin- 
fecting power  to  the  presence  of  the  hypo-chlorite  of  lime,  a  salt  which 
is  freely  soluble  in  water,  and  which  is  quickly  decomposed  by  contact 
with  organic  matter.  Germs  of  all  kinds,  including  the  most  resistant 
spores,  are  destroyed  by  this  solution,  but  it  must  be  remembered  that 
the  disinfectant  itself  is  quickly  decomposed  and  destroyed  by  contact 
with  organic  matter,  and  that  if  this  is  present  in  excess,  disinfection 
may  not  be  accomplished,  especially  when  the  germs  are  embedded  in 
masses  of  material  which  are  left  after  the  hypo-chlorite  of  lime  has  all 
been  exhausted  in  the  solution. 

5.  Liquor  Sodce  Chlorinatce  (Labarraque's  solution).  This  is  a  solu- 
tion of  the  hypo-chlorite  of  soda.  Its  value  as  a  disinfectant  corresponds 
with  that  of  solutions  of  the  hypo-chlorite  of  lime  of  the  same  strength. 
The  preparations  in  the  market  vary  greatly  in  value,  and  some  of  those 
tested  by  the  committee  on  disinfectants^  were  found  to  be  practically 
without  value.  This  is  due  to  the  fact  that  the  solution  does  not  keep 
well.  For  this  reason,  and  on  the  score  of  economvi  a  solution  of  chlo- 
ride of  lime  will  be  preferable  for  most  purposes.  Labarraque's  solution 
is,  however,  a  more  pleasant  preparation  for  bathing  the  surface  of  the 
body,  and  both  as  a  deodorant  and  a  disinfectant  will  be  found  useful  in 

1  See  Preliminary  Report  of  Committee  on  Disinfectants,  in  The  Medical  News,  Philadelphia, 
March  14,  1885,  p.  284. 

2  The  test  for  available  chlorine  is  given  in  Preliminary  Report  No.  11  of  the  Committee  on  Dis- 
infectants, 1.  c,  Jan.  7,  p.  148. 

2  1.  c,  p.  659. 


DISINFECTION.  1 1 1 

the  sick-room.  It  should  contain  at  least  3  per  cent,  of  available  chlo- 
rine. 

6.  Mercuric  Chloride  (bichloride  of  mercury,  corrosive  sublimate). 
This  salt  is  well  known  as  a  deadly  poison,-  which  has  long  been  used  in 
domestic  practice  as  a  "bug  poison,"  Recent  researches  show  that  .t 
has  germicide  powers  of  the  first  order,  and  it  is  consequently  a  disinfect- 
ant which  may  be  recommended  for  certain  purposes,  due  regard  being 
had  to  its  poisonous  nature,  and  to  the  fact  that  it  is  decomposed  by  con- 
tact with  lead,  tin,  or  copper,  and  that  lead  pipes  are  soon  rendered  brit- 
tle and  worthless  bypassing  through  them  solutions  of  mercuric  chloride. 
Its  potency  in  dilute  solutions  (i  :  500  to  i  :  4000)  makes  it  compara- 
tively cheap, ^  and  the  danger  of  accidental  poisoning  from  such  dilute 
solutions  is  not  very  great.  The  concentrated  solutions  should  be  col- 
ored, as  a  precaution  against  accident,  for  they  have  neither  color  nor 
odor  to  reveal  their  deadly  nature. 

A  standard  solution  which  contains  four  ounces  to  the  gallon  of  water 
is  of  convenient  sti^ength  for  a  concentrated  solution,  to  be  issued  by  man- 
ufacturers or  health  authorities,  in  properly  labelled  bottles.  This  may 
be  colored  with  permanganate  of  potash,^  or  with  indigo,  or  with  aniline 
blue.  Inasmuch  as  standard  solution  No.  2  of  the  committee  on  disin- 
fectants is  colored  with  the  permanganate,  it  would  perhaps  be  better 
to  give  this  solution  a  blue  color.  The  writer  would  suggest  the  follow- 
ing formula,  in  which  another  poisonous  metallic  salt  contained  in  our 
list  is  combined  with  the  mercuric  chloride  : 

Bichloride  of  mercury, 4  ounces. 

Sulphate  of  copper, i  pound. 

Water, i  gallon. 

It  must  be  remembered,  in  using  this  and  other  disinfecting  solutions, 
that  the  condition  relating  to  time  of  exposure  to  the  action  of  the  disin- 
fecting agent  is  an  important  one.  The  experimental  evidence'  relating 
to  the  germicide  power  of  mercuric  chloride  shows  that  the  time  of 
exposure  being  two  hours,  this  salt  may  be  safely  recommended  for  the 
destruction  of  spore-containing  infectious  material  in  the  proportion  of 
I  :  1000,  and  of  pathogenic  organisms  in  the  absence  of  spores  in  the 
proportion  of  i  :  4000,  or  even  less,  provided  that  the  7nicro-organisms 
to  be  destroyed  are  fairly  exposed  to  its  action.  The  fact  that  mercuric 
chloride  combines  with  and  coagulates  albuminous  material,  interferes 
to  some  extent  with  its  value  as  a  disinfectant,  and  will  be  kept  in  view 
in  the  recommendations  to  be  made  hereafter  relating  to  the  practical 
use  of  this  agent.  Mercuric  chloride  is  an  efficient  antiseptic  in  the  pro- 
portion of  I  :  15,000,  and  it  exercises  a  restraining  influence  upon  the 
development  of  the  spores  of  the  anthrax  bacillus,  when  present  in  cul- 
ture solutions,  in  the  proportion  of  i  :  300,000,  and  even  less. 

*  It  costs  about  fifty  cents  a  pound  by  the  quantity. 
'  Ten  grains  to  the  gallon  is  sufficient. 
s  The  Medical  News,  Feb.  21,  p.  205. 


112  DISINFECTION. 

y.  Dry  Heat.  Dry  heat  is  only  to  be  recommended  for  the  disinfec- 
tion of  such  articles  as  would  be  injured  by  exposure  to  moist  heat,  or  to 
a  disinfecting  solution.  A  properly  constructed  disinfection  chamber 
or  "  oven  "  is  absolutely  essential,  if  dry  heat  is  to  be  used.  The  experi- 
mental evidence  on  record  ^  shows  that  the  destruction  of  spores  requires 
a  temperature  which  would  injure  woollen  fabrics  (140°  C.  for  three 
hours) .  In  the  absence  of  spores,  however,  articles  which  are  freely  ex- 
posed for  two  hours  to  a  temperature  of  110°  C.  (230°  Fahr.)  may  with 
safety  be  considered  disinfected.  In  practice  it  will  be  necessary  to 
remember  that  the  penetrating  power  of  dry  heat  is  very  slight,  and  that 
packages,  bundles,  or  even  articles  loosely  thrown  one  upon  another,  can- 
not be  disinfected  in  this  way. 

8.  Sulphur  Dioxide  (sulphurous  acid  gas) .  Fumigation  with  burning 
sulphur  has  long  been  a  favorite  method  of  disinfection.  The  experience 
of  sanitarians  is  in  favor  of  its  use  in  yellow  fever,  small-pox,  scarlet 
fever,  diphtheria,  and  other  diseases  in  which  there  is  reason  to  believe 
that  the  infectious  material  does  not  contain  spores.  The  experimental 
evidence  on  record  "^  shows  that  under  certain  conditions  it  is  effective  for 
the  destruction  of  inicro-organisms  in  the  absence  of  spores,  but  that  it  is 
quite  Impotent  for  the  destruction  of  these  reproductive  elements. 

The  presence  of  moisture  adds  greatly  to  the  disinfecting  power  of  this 
agent.  It  is  freely  soluble  in  water,  one  volume  dissolving  fifty  volumes 
of  the  gas.  It  is  therefore  evident  that  a  saturated  aqueous  solution  is 
fifty  times  as  strong  as  the  pure  gas — anhydrous.  In  aqueous  solution, 
in  the  proportion  of  i  :  2000  by  weight,  sulphur  dioxide  kills  micrococci 
in  two  hours'  time.^  In  a  gas-tight  receptacle  it  destroys  the  infecting 
power  of  vaccine  virus  dried  upon  ivory  points,  when  present  in  the  pro- 
portion of  one  volume  per  cent.,  the  time  of  exposure  being  six  hours.* 
The  same  proportion  destroys  anthrax  bacilli,  without  spores,  from  the 
spleen  of  an  animal  recently  dead,  dried  upon  silk  threads,  in  thirty  min- 
utes (Koch) .  These  facts  show  that  sulphur  dioxide  is  a  valuable  dis- 
infectant ;  but  the  conditions  of  successful  disinfection,  as  established  by 
the  experimental  evidence,  are,  that  the  material  to  be  disinfected  shall  be 
freely  exposed  to  its  action  for  a  considerable  time,  in  a  receptacle  'which 
does  itot  permit  the  gas  to  escape.  It  must  be  remembered  that  disin- 
fection of  a  thin  layer  of  vaccine  virus  upon  an  ivory  point,  or  of  anthrax 
blood  upon  a  silk  thread,  exposed  in  a  gas-tight  receptacle,  cannot  be 
taken  as  evidence  that  thicker  layers  of  infectious  material,  attached  to 
the  surface  of  bedding  and  clothing,  or  enclosed  in  folded  blankets,  bun- 
dles of  clothing,  matresses,  etc.,  can  be  disinfected  by  the  same  amount 
of  sulphur  dioxide  generated  In  a  room  which  Is  not  gas-tight.  It  has 
been  shown,  by  carefully  conducted    experiments,^  that  the  escape  of 

'See  Medical  News,  March  14,  p.  283. 

*See  Prelim.  Rep.,  No.  VII,  The  Med.  News,  March  28,  p.  343. 

»1.  c.,p.  348. 

«  1.  c,  p.  344. 

"I.e.,  p.  347. 


DISINFECTION.  1 1 3 

sulphurous  acid  gas  from  a  bed-chamber  or  hospital  ward  is  veiy  rapid, 
in  spite  of  the  usual  precautions  for  stopping  up  crevices  when  such  a 
room  is  to  be  fumigated  ;  and  infectious  material,  enclosed  in  bundles  or 
protected  by  folds  of  blankets,  etc.,  may  escape  disinfection,  after  having 
been  exposed  for  many  hours  in  a  tightly  closed  chamber  containing  ten 
volumes  per  cent,  of  this  gas. 

g.  Carbolic  Acid.  The  disinfecting  power  of  carbolic  acid  has  been 
fixed  by  experiments  upon  vaccine  virus,  and  upon  various  pathogenic 
organisms.  A  saturated  aqueous  solution  cannot,  however,  be  relied 
upon  for  the  destruction  of  spores  ;  but  in  the  absence  of  spores  it  is  fatal 
to  micro-organisms  in  the  proportion  of  two  per  cent.,  the  time  of  expos- 
ure being  two  hours.  Indeed,  less  than  one  per  cent,  is  fatal  to  several 
of  the  species  of  pathogenic  micrococci  which  have  served  as  test-organ- 
isms in  the  numerous  experiments  which  have  been  made  with  this  agent. ^ 
Upon  the  recommendation  of  the  famous  Dr.  Koch,  the  discoverer  of  the 
cholera  bacillus,  the  committee  on  disinfectants,  of  the  International  San- 
itary Conference  of  Rome  (1885),  has  given  this  agent  the  first  place  for 
disinfecting  soiled  clothing,  excreta,  etc.,  in  cholera.  For  excreta  it  is 
to  be  used  in  five  per  cent,  solution,  and  for  clothing,  etc.,  in  two  per 
cent,  solution.  The  experimental  evidence  upon  record  indicates  that  it 
may  be  relied  upon  in  this  proportion. 

10.  Sulphate  of  Copper.  This  salt  has  been  largely  used  as  a  disin- 
fectant in  France,  and  recent  experiments  show  that  in  the  proportion  of 
one  per  cent,  it  is  a  reliable  agent  for  the  destruction  of  micro-organisms, 
in  the  absence  of  spores.  It  is  much  below  mercuric  chloride  in  germi- 
cide power,  but  is  a  better  deodorant — not  a  better  antiseptic — than  the 
more  poisonous  salt.  When  we  take  into  account  its  efficiency,  it  is  com- 
paratively cheap,  and  is  to  be  recommended  for  certain  purposes.  It 
may  be  combined  with  the  more  potent  germicide,  mercuric  chloride,  in 
accordance  with  the  formula  already  given. 

11.  Chloride  of  Zinc.  Solutions  of  chloride  of  zinc  are  largely  used 
in  this  country  and  in  Europe  for  disinfecting  purposes.  It  is  an  excel- 
lent antiseptic  and  deodorant,  but  its  power  to  destroy  disease  germs  has 
been  very  much  over-estimated.  It  may,  however,  be  relied  upon  for  the 
destruction  of  pathogenic  organisms,  in  the  absence  of  spores,  in  solu- 
tions which  contain  from  five  to  ten  per  cent,  of  the  salt. 

GENERAL,   DIRECTIONS    FOR    DISINFECTION. 

"  In  the  sick-room  we  have  disease  germs  at  an  advantage,  for  we  know 
where  to  find  them,  as  well  as  how  to  kill  them.  Having  this  knowl- 
edge, not  to  apply  it  would  be  criminal  negligence,  for  our  efforts  to  re- 
strict the  extension  of  infectious  diseases  must  depend  largely  upon  the 
proper  use  of  disinfectants  in  the  sick-room."  ^ 

^  Prelim.  Rep.  of  Com.  on  Disinfectants,  No.  VI,  1.  c,  p.  317. 
*  Prelim.  Rep.  of  Com.  on  Disinfectants  of  A.  P.  H.  A. 


1 14  disinfection: 

Disinfection  of  Excreta^  etc.  The  dejections  of  patients  suffering 
from  an  infectious  disease  should  be  disinfected  before  they  are  thrown 
into  a  water-closet  or  privy  vault.  This  is  especially  important  in  chol- 
era, typhoid  fever,  yellow  fever,  and  other  diseases  in  which  there  is  evi- 
dence that  the  infectious  agent  is  capable  of  self-multiplication,  in  suita- 
ble pabulum,  external  to  the  human  body.  Vomited  matters,  and  the 
sputa  of  patients,  with  these  and  other  infectious  diseases,  should  also  be 
promptly  disinfected.  This  is  especially  important  in  cholera,  diphthe- 
ria, scarlet  fever,  whooping-cough,  and  tuberculosis.  It  seems  advis- 
able, also,  to  treat  the  urine  of  patients  sick  with  an  infectious  disease 
■\vith  a  disinfecting  solution. 

For  the  disinfection  of  excreta,  etc.,  in  the  sick-room,  a  solution  of 
chloride  of  lime  is  to  be  recommended.  This  is  an  excellent  and  prompt 
deodorant,  as  well  as  a  disinfectant.  A  quart  of  the  standard  solution 
(No.  i),  recommended  by  the  committee  on  disinfectants,  of  the  Amer- 
ican Public  Health  Association,  will  suffice  for  an  ordinary  liquid  dis- 
charge in  cholera  or  typhoid  fever  ;  but  for  a  copious  discharge  it  will  be 
prudent  to  use  twice  this  quantity,  and  for  solid  fecal  matter  a  stronger 
solution  will  be  required.  As  chloride  of  lime  is  quite  cheap,  it  will 
be  best  to  keep  on  the  safe  side,  and  to  make  the  solution  for  the  disin- 
fection of  excreta  by  dissolving  eight  ounces  of  chloride  of  lime  in  a  gal- 
lon of  water.  This  solution  should  be  placed  in  the  vessel  before  it 
receives  the  discharge.  The  material  to  be  disinfected  should  be  well 
mixed  with  the  disinfecting  solution  by  agitating  the  vessel,  and  from 
thirty  minutes  to  an  hour  should  be  allowed  for  the  action  of  the  disin- 
fectant, before  the  contents  are  thrown  into  a  water-closet  or  privy  vault. 

Stafidard  Solution  No.  ^,  of  the  committee  on  disinfectants,  which 
contains  two  drachms  of  corrosive  sublimate  and  two  drachms  of  per- 
manganate of  potash  to  the  gallon  of  water,  if  used  freely — one  quart  for 
each  dejection — and  left  in  contact  with  the  material  to  be  disinfected  for 
at  least  four  hours,  is  a  reliable  disinfectantybr  liquid  discharges.  The 
caution  with  reference  to  lead  pipes  must  be  remembered,  and  if  this 
solution  is  used  in  the  sick-room  or  in  hospital  wards,  it  will  be  desirable 
to  have  receptacles  of  wood  or  earthern  ware  for  the  disinfected  material, 
which  may  be  carried  away  and  emptied  in  a  suitable  locality  once  in 
twenty-four  hours. 

The  blue  solution  heretofore  suggested  would  also  be  suitable  for  use 
in  the  same  way,  and  with  the  same  precautions.  It  contains  four  ounces 
of  corrosive  sublimate  and  a  pound  of  sulphate  of  copper  to  the  gallon  of 
water.  This  concentrated  solution  should  be  diluted  in  the  proportion 
of  eight  ounces  to  the  gallon  of  water,  and  the  diluted  solution  used  as 
heretofore  recommended — at  least  a  quart  for  each  dejection,  and  four 
hours'  time.  The  disinfecting  power  of  the  copper  salt  adds  to  the  value 
of  this  solution,  and  the  bright  blue  color  of  the  concentrated  solution 
leaves  nothing  to  be  desired  in  the  way  of  a  color  protection  against  acci- 
dental poisoning. 

For  the  disinfection  of  the  discharges  of  cholera  j^atients,  a  five  per 


DISINFECTION.  1 1 5 

cent,  solution  of  carbolic  acid  may  be  used,  in  accordance  with  the  rec- 
ommendation of  the  International  Sanitary  Conference  of  Rome.  The 
time  necessary  to  insure  disinfection  is  fixed  at  four  hours.  . 

Chloride  of  zinc  in  ten  per  cent,  solution  may  be  used  for  the  dejec- 
tions of  cholera  patients,  the  same  conditions  being  observed  in  regard  to 
quantity  and  time  of  exposure  as  were  fixed  for  the  other  metallic  salts 
named. 

It  will  be  best  to  burn  cloths  used  to  wipe  away  the  discharges  of  the 
sick,  and  especially  those  used  in  wiping  away  the  infectious  material 
from  the  mouth  and  nostrils  of  patients  with  diphtheria  or  scarlet  fever. 
Bits  of  old  muslin  may  be  used  for  this  purpose,  and  should  at  once  be 
thrown  upon  an  open  fire  or  gas  stove  arranged  in  the  fire-place  for  this 
purpose. 

Infected  sputum  may  be  discharged  directly  into  a  cup  naif  full  of  the 
solution  of  chloride  of  lime  recommended  for  excreta,  or  of  Labarraque's 
solution. 

Handkerchiefs,  napkins,  and  towels  used  in  wiping  away  infectious 
discharges,  if  worth  preserving,  should  be  at  once  immersed  in  one  of  the 
following  solutions:  Chloride  of  lime,  2  per  cent.  ;  carbolic  acid,  2  per 
cent.  ;  mercuric  chloride,  o.i  per  cent.  (rr:i  :  looo). 

The  blue  solution  (containing  sulphate  of  copper) ,  diluted  in  the  pro- 
portion of  four  ounces  to  the  gallon  of  water,  may  also  be  used  for  this 
purpose.  Cloths  used  for  washing  the  general  surface  of  the  body  should 
also  be  disinfected  with  one  of  the  above  mentioned  solutions  ;  and  attend- 
ants should  invariably  disinfect  their  hands  by  washing  them  in  one  of 
these  solutions,  when  they  have  been  soiled  by  the  discharges  of  the 
sick. 

Disinfection  of  the  Person.  Labarraque's  solution,  diluted  with 
twenty  parts  of  water,  is  a  suitable  disinfecting  solution  for  bathing  the 
entire  surface  of  the  body  of  the  sick,  of  convalescents,  or  of  those  whose 
duties  take  them  into  the  sick-room  ;  or  a  i  per  cent,  solution  of  chloride 
of  lime,  or  a  2  per  cent,  solution  of  carbolic  acid,  may  be  used. 

The  International  Sanitary  Conference  of  Rome  gives  the  following 
directions  with  reference  to  the  disinfection  of  the  body  after  death  from 
cholera  : 

"  The  body  should  be  enveloped  in  a  sheet  saturated  with  one  of  the 
strong  disinfecting  solutions,^  without  previous  washing,  and  should  at 
once  be  placed  in  a  coffin." 

We  see  no  objection  to  washing  the  body,  if  the  strong  solution  of 
chloride  of  lime  is  used  for  this  purpose.  Washing  with  water  would 
necessitate  the  careful  disinfection  of  the  water  and  cloths  used  for  this 
purpose,  and  of  the  hands  of  the  attendants.  As  the  odor  of  chlorine  or 
of  carbolic  acid  would  be  objectionable  under  certain  circumstances,  we 
see  no  good  reason  for  insisting  upon  the  use  of  these  agents,  rather  than 
on  the  odorless  solution  of  mercuric  chloride,  which,  in  the  proportion  of 
I  :  looo,  would  no  doubt  be  equally  effective.     But  when  there  is  an 

1  Chloride  of  lime  4  per  cent.,  or  carbolic  acid  5  per  cent. 


1 1 6  disinfection: 

odor  of  decomposition  to  be  neutralized,  the  solution  of  chloride  of  lime 
will  have  a  decided  advantage  on  account  of  its  deodorizing  properties. 

Disinfectio7i  of  Clothing  and  Bedding.  The  cheapest  and  best  way 
of  disinfecting  clothing  and  bedding,  which  is  not  injured  by  the  ordinary 
operations  of  the  laundry,  is  to  immerse  it  in  boiling  water  for  half  an 
hour  or  longer.  It  should  be  placed  in  boiling  water  as  soon  as  removed 
from  the  person  or  the  bed  of  the  sick,  and  if  it  is  necessary  to  remove 
the  articles  from  the  room  in  order  to  accomplish  this,  they  should  be 
wrapped  in  a  sheet  or  towel  thoroughly  saturated  with  a  disinfecting  so- 
lution. If  it  is  impracticable  to  disinfect  such  infected  clothing  and  bed- 
ding immediately  by  boiling,  it  will  be  necessary  to  immerse  it  in  one  of 
the  following  disinfecting  solutions,  in  which  it  should  be  left  for  four 
hours:  Mercuric  chloride,  i  :  2000;  or  the  "blue  solution"  of  this  salt  and 
sulphate  of  copper,  diluted  by  adding  two  fluid  ounces  of  the  concen- 
trated solution  to  a  gallon  of  water  ;  or  a  2  per  cent,  solution  of  carbolic 
acid.  The  solution  of  chlorinated  lime  (2  per  cent.)  may  also  be  used, 
but  we  give  the  precedence  to  the  first  mentioned  solutions,  because  of 
the  bleaching  properties  of  this  solution.  The  blue  solution  does  not  in- 
jure clothing,  and  is  to  be  preferred  for  domestic  use  to  a  simple  solution 
of  corrosive  sublimate,  which  in  the  concentrated  form  is  highly  poison- 
ous, and  without  odor  or  color.  When  diluted  as  directed,  this  solution 
may,  however,  be  used  without  danger  either  from  absorption  through 
the  hands,  or  by  drinking.  The  metallic  taste  of  the  diluted  solution 
could  scarcely  fail  to  prevent  a  fatal  dose  from  being  swallowed  acci- 
dentally. 

For  outer  clothing,  and  other  articles  which  would  be  seriously  injured 
by  immersion  in  boiling  water,  the  best  disinfectant  is  steam.  Exposure 
to  steam  at  100°  C.  (212°  Fahr.)  for  half  an  hour  would  be  equivalent  to 
exposure  in  boiling  water  for  the  same  time,  if  the  clothing  is  hung  up  in 
such  a  manner  as  to  be  fairly  brought  under  tlie  action  of  the  disinfecting 
agent.  To  be  certain  that  the  steain  does  not  fall  below  this  temperature 
in  the  disinfection  chamber,  a  thermometer  must  be  placed  in  a  corner  of 
the  room,  at  a  distance  from  the  point  of  entrance  of  the  steam,  or  in  an 
aperture  from  which  the  steam  escapes.  This  should  mark  at  least  100°  C. 
for  half  an  hour  before  the  disinfection  can  be  considered  complete.^  To 
accomplish  this,  it  is  evident  that  the  steam  must  come  from  the  gener- 
ator at  a  higher  temperature,  or,  in  other  words,  must  be  under  pressure. 

It  must  be  remembered  that  the  destruction  of  spores  is  the  most  diffi- 
cult test  of  disinfecting  power  known,  and  one  which  excludes  the  use  of 
carbolic  acid,  sulphur  dioxide,  and  other  agents  which  enjoy  the  confi- 
dence of  sanitarians,  and  which  have  been  proved  by  laboratory  experi- 
ments to  destroy  pathogenic  organisms  in  the  absence  of  spores.  There 
is  good  reason  for  the  belief  that  dry  heat  and  sulphurous  acid  gas  may 
be  safely  substituted  for  steam  for  the  disinfection  of  the  clothing  of  pa- 
tients with  cholera,  yellow  fever,  and  small-pox,  and  probably  in  several 

»  The  committee  on  disinfectants  of  the  International  Sanitary  Conference  of  Rome  fixes  one 
hour  as  the  time  during  which  steam  should  be  made  to  pass  over  the  articles  to  be  disinfected. 


DISINFECTION.  1 1/ 

other  infectious  diseases  (puerperal  fever,  erysipelas,  diphtheria  ( ?) ,  and 
scarlet  fever  (  ?)  ) 

As  disinfection  by  steam  will  injure  certain  articles,  dry  heat  may  be 
used  as  a  substitute  for  moist  heat,  but  in  this  case  a  temperature  of  at 
least  iio°  C.  (330°  Fahr.),  maintained  for  two  hours,  will  be  required. 
In  the  use  of  dry  heat,  even  greater  care  is  necessary  that  the  articles  to 
be  disinfected  are  freely  exposed, — that  is,  not  placed  in  the  oven  in  bun- 
dles, or  piled  one  upon  another,  but  freely  suspended  in  the  disinfecting 
chamber.  For  it  has  been  shown  by  carefully  conducted  experiments 
that  the  penetrating  power  of  dry  heat  is  very  slight.  A  properly  con- 
structed disinfection  oven,  such  as  that  of  Ransom,^  will  be  required  if 
dry  heat  is  to  be  used. 

As  the  appliances  for  disinfecting  with  steam  or  with  dry  heat  are 
somewhat  expensive,  these  agents  are  not  likely  to  supplant,  for  general 
use,  the  time-honored  practice  of  fumigation  with  sulphurous  acid  gas. 
This  method  of  disinfection  commends  itself  because  of  the  cheapness  of 
the  material  used,  and  the  facility  of  its  application.  Sulphur  dioxide  is 
a  less  reliable  disinfectant  than  steam  or  dry  heat,  but  when  the  necessary 
conditions  are  observed  there  is  no  doubt  of  its  utility  ;  and  the  fact  that 
it  does  not  kill  the  spores  of  anthrax  and  of  other  bacilli  is  no  reason  for 
rejecting  an  agent  which  has  been  demonstrated  by  experience  to  be  one 
of  great  value,  which  has  been  proved  by  laboratory  experiments  to  be 
fatal  to  pathogenic  organisms  in  the  absence  of  spores,  and  to  destroy  the 
infecting  power  of  vaccine  virus.  But  in  using  this  agent  the  conditions 
of  successful  disinfection,  which  have  been  established  by  experiment, 
should  be  borne  in  mind.  The  room  which  is  to  serve  as  a  disinfecting 
chamber  must  be  very  thoroughly  closed :  every  crevice  and  key-hole 
should  be  carefully  stopped  with  cotton,  or  by  fastening  paper  over  it. 
Even  this  precaution  will  not  prevent  the  rapid  escape  of  gas  from  cracks 
around  doors,  windows,  etc.  It  is  therefore  desirable,  when  practicable, 
to  use  a  disinfecting  chamber  which  can  be  hermetically  closed.  The 
articles  to  be  disinfected  must  be  very  freely  exposed,  and  should  never 
be  thrown  into  the  room  in  bundles,  or  piled  one  upon  another.  We 
concur  in  the  recommendations  of  the  committee  on  disinfectants  of  the 
American  Public  Health  Association,  as  to  the  amount  of  sulphur  which 
should  be  burned,  and  the  method  of  effecting  its  complete  combustion  : 

"  To  secure  any  result  of  value,  it  will  be  necessary  to  close  the  apart- 
ment to  be  disinfected  as  completely  as  possible,  by  stopping  all  apertures 
through  which  gas  might  escape,  and  to  burn  at  least  three  pounds  ot 
sulphur  for  each  thousand  cubic  feet  of  air-space  in  the  room.  To  secui'e 
complete  combustion  of  the  sulphur,  it  should  be  placed,  in  powder  or  in 
small  fragments,  in  a  shallow  iron  pan,  which  should  be  set  upon  a 
couple  of  bricks  in  a  tub  partly  filled  with  water,  to  guard  against  fire. 
The  sulphur  should  be  thoroughly  moistened  with  alcohol  before  igniting 
it."  2 

1  British  Medical  jfournal,  Sept.  6,  1873,  p.  274. 

2  Preliminary  Report,  I.  c,  p.  427. 


Il8  ■    DISINFECTION. 

Finally,  we  would  remark,  that  in  the  absence  of  suitable  appliances 
for  disinfection,  and  in  general  when  the  infected  articles  are  of  little 
value,  consumption  by  fire  furnishes  the  readiest  and  safest  method  of 
disposing  of  such  articles. 

For  articles  of  value,  such  as  upholstered  furniture,  etc.,  which  would 
be  injured  by  any  of  the  processes  heretofore  recommended,  free  exposure 
to  the  air  (aeration)  for  three  or  four  weeks  is  directed  by  the  committee 
on  disinfectants  of  the  International  Sanitary  Conference  of  Rome.  The 
same  committee  directs  that  "  objects  made  of  leather,  such  as  trunks, 
boots,  etc.,  should  be  destroyed,  or  washed  several  times  with  one  of  the 
weak  disinfection  solutions," — carbolic  acid  2  per  cent.,  or  chloride  of 
lime  I  per  cent. 

The  means  heretofore  recommended  for  the  disinfection  of  woollen 
clothing,  blankets,  and  similar  articles  will  not  be  sufficient  for  soiled 
mattresses.  As  a  rule,  they  should  be  opened,  and  the  contents  disin- 
fected by  steam  or  by  dry  heat,  with  subsequent  free  aeration,  and  the 
cover  should  be  washed  in  boiling  water  after  treatment  with  a  disinfect- 
ing solution. 

Disinfection  of  the  Sick- Room.  Every  effort  should  be  made  to 
prevent  a  room  occupied  by  patients  sick  with  an  infectious  disease  from 
becoming  infected.  Carpets,  stuffed  furniture,  curtains,  and  other  arti- 
cles difficult  to  disinfect,  should  be  removed  at  the  outset.  Indeed,  noth- 
ing should  be  left  in  the  room  which  is  not  absolutely  required,  and  all 
furniture  and  utensils  should  be  of  such  a  character  that  they  can  be 
readily  disinfected  by  washing  with  boiling  water  or  with  a  disinfecting 
solution.  Abundant  ventilation  and  scrupulous  cleanliness  should  be 
maintained,  and  a  disinfecting  solution  should  always  be  at  hand  for 
washing  the  floor,  or  articles  in  use,  the  moment  they  are  soiled  by  infec- 
tious discharges.  For  this  purpose  a  solution  of  chloride  of  lime  may  be 
used  (4  per  cent.). 

It  is  impracticable  to  destroy  infectious  material  in  an  occupied  apart- 
ment by  means  of  gases  or  volatile  disinfectants,  for  to  be  effective  these 
must  be  used  in  a  degree  of  concentration  which  would  make  the  atmos- 
phere of  a  room  quite  irrespirable.  These  agents  are  therefore  useful 
only  as  deodorants.  They  are  all  more  or  less  offensive  to  the  sick,  and 
will  seldom  be  required,  even  as  deodorants,  when  proper  attention  is 
paid  to  cleanliness  and  ventilation. 

Daily  wiping  of  all  surfaces — floors,  walls,  and  furniture — with  a  cloth 
wet  with  a  disinfecting  solution,  is  to  be  recommended.  For  this  pur- 
pose a  solution  of  chloride  of  lime  (2  per  cent.),  or  of  carbolic  acid  (2 
per  cent.),  or  of  mercuric  chloride  (i  :  2000),  may  be  used. 

By  such  precautions  as  have  been  indicated,  the  infection  of  the  sick- 
room may  be  prevented,  especially  in  those  diseases,  such  as  cholera  and 
typhoid  fever,  in  which  the  infectious  agent  is  not  given  off' in  the  breath, 
or  from  the  general  surfiice  of  the  body,  of  the  sick  person.  In  small- 
pox and  in  scarlet  fever  there  is  greater  danger  that  the  infectious  agent 
may  remain  attached  to  surfaces  in  the  room  ;  for  the  atmosphere  be- 


DISINFECTION.  II9 

comes  infected  with  particles  given  off  from  the  surface  of  the  patient's 
body. 

As  already  stated,  the  atmosphere  cannot  be  disinfected  while  the  room 
is  occupied.  There  is  much  less  reason  for  disinfecting  it  when  the  pa- 
tient has  been  removed,  and  it  is  much  simpler  to  renew  it  by  throwing 
open  the  doors  and  windows  than  to  attempt  to  disinfect  it.  Indeed, 
there  will  be  no  infectious  particles  to  destroy,  except  such  as  are  dis- 
lodged from  surfaces,  window  ledges,  etc.,  where  they  have  settled  as 
dust  while  the  room  was  occupied  ;  and  if  the  precautions  above  recom- 
mended have  been  taken,  the  danger  of  such  reinfection  of  the  atmos- 
phere will  be  reduced  to  a  minimum. 

Disinfection  of  the  vacated  room,  then,  consists  in  the  destruction  of 
all  infectious  particles  which  remain  attached  to  surfaces,  or  lodged  in 
crevices,  in  interstices  of  textile  fabrics,  etc.  The  object  in  view  may 
be  accomplished  by  thorough  washing  with  one  of  the  disinfecting  solu- 
tions heretofore  recommended ;  but  most  sanitarians  think  it  advisable, 
first,  to  fumigate  the  room  with  sulphur  dioxide.  This  practice  is  to  be 
recommended,  and  the  directions  given  by  the  committee  on  disinfectants, 
already  quoted,  should  be  followed  (3  lbs.  of  sulphur  to  1,000  cubic  feet 
of  air  space) .  At  the  end  of  from  twelve  to  twenty-four  hours,  doors  and 
windows  should  be  opened,  and  the  room  freely  ventilated.  After  this 
fumigation,  all  surfaces  should  be  washed  with  a  disinfecting  solution 
(chloride  of  lime  3  per  cent.,  carbolic  acid  2  per  cent.,  or  mercuric 
chloride  l  :  1000),  and  afterwards  thoroughly  scrubbed  with  soap  and  hot 
water.  Plastered  walls  should  be  white-washed.  The  fumigation  rec- 
ommended is  especially  important  in  the  case  of  rooms,  the  walls  of 
which  are  covered  with  paper,  and  in  rooms  from  which  curtains,  car- 
pets, etc.,  have  not  been  removed;  and  under  these  circumstances  it 
will,  as  a  rule,  be  advisable  to  repeat  the  fumigation  a  second  or  even  a 
third  time.  The  process  is  inexpensive,  and  the  old  saying  that  ''  What- 
ever is  worth  doing  at  all  is  worth  doing  well,"  applies  with  especial 
force  to  the  use  of  disinfectants.  Excessive  precaution  can  do  no  harm, 
but  the  inefficient  use  of  disinfecting  agents,  which  results  from  indiffer- 
ence, or  from  ignorance  of  the  precise  value  of  the  agents  relied  upon, 
may  be  disastrous. 

Disinfection  of  Privy  Vaults.,  Cesspools .,  etc.  The  contents  of  privy 
vaults  and  cesspools  should  never  be  allowed  to  accumulate  unduly,  or  to 
become  ofliensive.  By  frequent  removal,  and  by  the  liberal  use  of  anti- 
septics, such  necessary  receptacles  of  filth  should  be  kept  in  a  sanitary 
condition.  The  absorbent  deodorants,  such  as  dry  earth,  or  pounded 
charcoal, — or  the  chemical  deodorants  and  antiseptics,  such  as  chloride  of 
zinc,  sulphate  of  iron,  etc., — will,  under  ordinary  circumstances,  prevent 
such  places  from  becoming  offensive.  Disinfection  will  only  be  required 
when  it  is  known,  or  suspected,  that  infectious  material,  such  as  the  de- 
jections of  patients  with  cholera,  yellow  fever,  or  typhoid  fever,  has  been 
thrown  into  the  receptacles,  which  are  especially  dangerous,  because  they 
already  contain  pabulum  suitable  for  the  development  of  the  germs  of 


I20  DISINFECTION. 

these  diseases.  Mercuric  chloride  commends  itself  especially  for  the 
disinfection  of  such  masses  of  material,  because,  even  if  any  germs 
escape  immediate  destruction,  they  will  fail  to  multiply  in  the  presence 
of  this  potent  antiseptic.  Tlie  chloride  of  lime  solution,  on  the  contrary, 
is  preferable  for  use  in  the  sick-room,  because  of  the  promptness  and 
certahity  of  its  germicide  action  and  its  deodorizing  power.  But  it  has 
the  disadvantage,  where  large  masses  of  material  are  to  be  disinfected, 
that  it  is  itself  destroyed  by  contact  with  organic  matter  ;  and  that  if 
there  is  a  surplus  of  infectious  material  after  the  disinfecting  solution  has 
been  neutralized,  this  will  be  as  potent  for  mischief  as  a  larger  quantity 
would  have  been. 

Mercuric  chloride  should  be  used  in  solution.^  in  the  proportion  of 
"  one  pound  for  every  five  hundred  pounds — estimated — of  fecal  matter 
contained  in  the  vault.  ^  All  exposed  portions  of  the  vault,  and  the 
wood-work  above  it,  should  be  thoroughly  washed  down  with  the  disin- 
fecting solution."* 

The  subsequent  daily  use  of  a  smaller  quantity  of  the  same  solution 
would  ensure  the  continued  disinfection  of  fresh  material  thrown  into  the 
vault.  Or  chloride  of  lime  in  powder  may  be  freely  scattered  over  the 
contents  after  the  first  disinfection  with  mercuric  chloride.  A  diluted 
powder,  made  by  mixing  one  pound  of  chloride  of  lime  with  nine  pounds 
of  plaster  of  Paris,  or  of  clean,  well  dried  sand,  may  be  used  for  this  pur- 
pose. This  is  more  easily  spread  about,  can  be  used  more  economically, 
and  is  sufliciently  strong  in  chlorine  for  practical  purposes.  As  chloride 
of  lime  is  an  excellent  deodorant  as  well  as  a  disinfectant,  such  a  powder 
commends  itself  for  general  use  in  open  privy  vaults  and  cesspools,  not 
only  during  the  prevalence  of  epidemics,  but  at  all  times  when  they  give 
evidence  of  being  in  an  unsanitary  condition. 

Hospitals.  The  directions  already  given  in  regard  to  disinfection  of 
the  sick-room  and  its  contents  apply  as  well  to  hospital  wards  in  which 
patients  with  infectious  diseases  are  treated.  In  addition  to  this,  it  will 
be  necessary  in  hospitals  to  guard  against  such  infectious  diseases  as 
erysipelas,  septicaemia,  puerperal  fever,  and  hospital  gangrene.  The 
antiseptic  treatment  of  wounds,  in  connection  with  a  proper  regard  for 
cleanliness  and  ventilation,  has  practically  banished  these  diseases  from 
well  regulated  hospitals.  Of  the  first  importance  in  effecting  this  are  the 
precautions  now  taken  with  reference  to  the  disinfection  of  sponges,  in- 
struments, the  hands  of  attendants,  etc. 

Instruments  of  silver,  such  as  probes  and  catheters,  may  be  disinfected 
by  passing  them  through  the  flame  of  an  alcohol  lamp.  Instruments  of 
steel,  gum  catheters,  etc.,  may  be  disinfected  by  immersion  in  a  five  per 
cent,  solution  of  carbolic  acid,  or  in  a  i  :  looo  solution  of  mercuric  chlo- 
ride.    For  instruments   and   vessels  of  copper,  brass,   and  tin,  boiling 

>  Recent  experiments  made  by  the  writer  make  it  apparent  that  the  complete  sterilization  of  large 
masses  of  fecal  matter  in  privy  vaults  would  be  a  difficult  and  expensive  undertaking,  if  not  entirely 
impracticable.  It  is  therefore  of  prime  importance  that  infectious  material  should  be  destroyed  be- 
fore it  is  thrown  into  a  receptacle  of  this  kind. 

*  Prelim.  Rep.  of  Com.  on  Disinfectants,  1.  c. 


DISINFECTION.  1 2 1 

water,  or  the  carbolic  acid  solution,  may  be  used.  Vessels  of  porcelain 
or  glass  may  be  disinfected  by  heat,  or  by  either  of  the  disinfecting  solu- 
tions mentioned.  Sponges  should  be  kept  permanently  in  one  of  the  dis- 
infecting solutions,  or,  what  is  better,  may  be  dispensed  with  entirely  for 
the  cleansing  of  wounds.  In  place  of  them,  irrigation  with  a  disinfecting 
solution  may  be  resorted  to,  or  the  discharges  may  be  wiped  away  with 
some  cheap  absorbent  material  which  can  be  burned  after  having  been 
once  used. 

Patients  in  hospitals,  with  infectious  diseases,  will  of  course  be  kept  in 
isolated  wards.  Everything  which  comes  from  such  a  ward  should  be 
disinfected,  and  the  immediate  attendants  of  the  sick  should  not  be 
allowed  to  visit  other  parts  of  the  hospital  without  first  changing  their 
outer  clothing  for  a  recently  disinfected  suit,  and  washing  their  hands  in 
a  disinfecting  solution.  When  relieved  from  duty  their  underclothing 
should  also  be  disinfected  ;  and  they  should  take  a  complete  bath  with 
one  of  the  weak  disinfecting  solutions  heretofore  recommended. 

Every  hospital  should  be  provided  with  a  steam  disinfecting  apparatus, 
or  with  an  oven  for  disinfection  by  dry  heat. 

Disinfection  of  Water  and  Articles  of  Food.  The  disinfection  of 
drinking-water  on  a  large  scale,  in  resei-voirs,  v^^ells,  etc.,  is  impractica- 
ble. But  it  is  a  very  simple  matter  to  disinfect  water  which  is  suspected 
of  being  contaminated  with  the  germs  of  cholera,  typhoid  fever,  or  any 
other  disease  transmissible  in  this  way.  This  is  readily  accomplished  by 
boiling.  As  already  stated,  all  known  disease  germs  are  destroyed  by 
the  boiling  temperature  maintained  for  half  an  hour.  The  importance  of 
this  precaution  during  the  prevalence  of  an  epidemic  of  cholera  or  of 
typhoid  fever  cannot  be  over-estimated,  when  the  water  used  for  drinking 
purposes  comes  from  an  impure  source,  or  is  liable  to  contamination  by 
the  discharges  of  patients  suffering  from  these  diseases.  Those  articles 
of  food,  and  especially  milk,  animal  broths,  etc.,  which  might  serve  as 
pabulum  for  disease  germs,  should,  during  the  prevalence  of  an  epidemic, 
be  cooked  but  a  short  time  before  they  ai'e  eaten.  And  such  food,  if  put 
aside  for  some  hours  after  it  has  been  prepared,  should  always  be  again 
subjected  to  a  boiling  temperature  shortly  before  it  is  served.  Food 
which  gives  evidence  of  commencing  putrefaction  is  unfit  for  use,  and  in 
time  of  epidemics  is  especially  dangerous. 

Disinfection  of  Ships.  It  should  be  the  aim  of  a  physician  attached 
to  a  passenger  ship,  or  of  the  master  of  a  vessel  having  no  physician  on 
board,  to  prevent  the  vessel  from  becoming  infected  when  in  an  infected 
port,  or  when  cases  of  infectious  disease  occur  on  boai'd.  This  is  to  be 
accomplished  by  keeping  the  ship  clean  ;  by  disinfecting  suspected  arti- 
cles, and  especially  the  soiled  clothing  of  passengers,  before  they  are 
received  on  board  ;  by  the  isolation  of  cases  of  infectious  disease  w^hich 
occur  on  board  ;  and  by  the  thorough  execution  of  those  measures  of  dis- 
infection recommended  for  the  sick-room.  When  a  case  of  cholera  or  of 
yellow  fever  occurs  upon  a  ship  at  sea,  it  cannot  be  taken  as  evidence 
that  the  vessel  is  infected  unless  at  least  five  days  have  elapsed  since  the 


122  DISINFECTION. 

person  attacked  came  on  board.  For  he  may  have  contracted  the  disease 
from  exposure  at  the  port  of  departure,  or  in  some  other  locaHty  on  shore. 
When,  however,  a  longer  time  than  this  has  elapsed,  or  when  several 
cases  develop  in  a  particular  locality  on  ship-board,  either  simultaneously 
or  successively,  the  vessel  must  be  considered  infected,  unless  it  is  shown 
that  the  cases  are  directly  due  to  the  opening  of  baggage  containing  in- 
fected clothing. 

In  practice,  the  sanitary  officials  at  the  port  of  arrival  usually  treat  a 
vessel  as  infected  if  any  cases  of  infectious  disease  have  occurred  upon 
her  during  the  voyage.  This  is  a  safe  general  rule,  which  should  not 
be  departed  from  unless  a  considerable  time — five  to  seven  days — has 
elapsed  since  the  cases  occurred,  and  they  can  be  clearly  traced  to  expos- 
ure before  coming  on  board.  In  this  case,  if  the  ship  is  clean  and  the 
precautions  relating  to  disinfection  and  isolation  of  the  sick  have  been 
faithfully  executed,  the  health  officer  may  be  justified  in  dispensing  with 
the  general  measures  of  disinfection  which  are  required  for  an  infected 
ship. 

These  measures  do  not  differ  from  those  heretofore  recommended  for 
the  disinfection  of  the  sick-room  and  its  contents  ;  but  the  special  condi- 
tions on  ship-board,  and  the  great  interests  at  stake,  make  it  essential 
that  the  execution  of  these  measures  should  be  in  the  hands  of  sanitary 
experts. 

In  the  disinfection  of  ships,  fumigation  with  sulphurous  acid  gas  is  a 
measure  of  prime  importance,  and  is  largely  practised  by  those  in  charge 
of  quarantine  establishments.  The  fact  that  the  ship  may  be  almost  her- 
metically closed,  and  the  escape  of  gas  to  a  great  extent  prevented,  makes 
this  method  of  disinfection  more  trustworthy  than  in  the  case  of  dwellings 
and  hospitals.  The  further  fact,  that  certain  parts  of  the  ship  are  inac- 
cessible for  the  application  of  disinfecting  solutions,  seems  to  make  the 
use  of  a  gaseous  disinfectant  imperative. 

Disinfection  by  means  of  steam,  especially  of  an  iron  vessel,  would  no 
doubt  be  a  difficult  matter  on  account  of  the  condensation  which  would 
occur  from  contact  with  the  cool  walls  of  the  vessel  below  the  water-line. 
But  it  will  be  well  to  fill  the  vessel  with  steam  before  introducing  the 
sulphur  dioxide  ;  for,  as  already  stated,  the  disinfecting  power  of  this 
agent  is  much  greater  in  presence  of  moisture.  A  well  equipped  quar- 
antine establishment  should  have  an  apparatus  for  generating  sulphurous 
acid  gas,  and  injecting  it  into  vessels,  as  this  is  the  most  expeditious  and 
satisfactory  method  of  fumigating  a  ship.^ 

An  essential  part  of  the  disinfection  of  a  ship  will  consist  in  the 
thorough  cleansing  of  the  bilge.  The  International  Sanitary  Conference 
of  Rome  prescribes  that  the  bilge  water  shall  be  pumped  out  and  re- 
placed by  sea  water  at  least  twice  at  each  disinfection  of  the  vessel. 
This  is  very  well  so  far  as  it  goes,  but  we  would  also  recommend  that 
after  such  cleansing,  the  potent  disinfectant,  mercuric  chloride,  be  added 

'  The  New  Orleans  quarantine  establishment  is  provided  with  an  apparatus  of  this  kind,  which 
seems  to  be  well  adapted  for  the  purpose.  See  paper  by  Dr.  Joseph  Holt,  in  the  annual  report  of 
the  A.  P.  H.  A.  for  1884. 


DISINFECTION.  1 23 

to  the  clean  sea-water  remaining  in  the  bilge  in  the  proportion  of  one 
pound  to  the  ton  of  water — estimated.  In  the  case  of  ships  sailing  from 
ports  infected  with  yellow  fever,  it  would  be  a  wise  precaution,  after  the 
cleansing  of  the  bilge  at  the  point  of  departure,  to  throw  the  same 
amount  of  mercuric  chloride,  dissolved  in  salt  water,  into  the  bilge,  and 
to  add  a  smaller  quantity  of  the  same  solution  at  intervals  during  the 
voyage. 

Merchandise.  Article  V,  of  the  Report  of  the  Committee  on  Disin- 
fectants of  the  International  Sanitary  Conference  of  Rome,  says, — 

"V.  Disinfection  of  merchandise  and  of  the  mails  is  unnecessary. 
(Steam  under  pressure  is  the  only  reliable  agent  for  the  disinfection  of 
rags, — les  chiffons  en  gros.')" 

We  think  this  statement  too  broad,  especially  so  far  as  merchandise  is 
concerned  which  has  been  on  board  a  ship  infected  with  yellow  fever. 
The  poison  of  this  disease  seems  to  be  capable  of  self-multiplication  on  a 
foul  ship  in  tropical  latitudes,  quite  independently  of  passengers  and 
crew.  And  there  is  ample  evidence  that  even  when  no  case  has 
occurred  on  an  infected  ship  at  sea,  those  who  are  engaged  in  discharg- 
ing her  cargo  after  her  arrival  in  port  may  be  seized  with  yellow  fever 
from  breathing  the  infected  atmosphere  of  the  hold.  Evidently  mer- 
chandise conveyed  on  such  a  ship  should  be  disinfected.  But  it  does  not 
seem  necessary  to  break  packages  v^hich  have  gone  on  board  in  good 
condition,  arid  a  thorough  fumigation  with  sulphurous  acid  gas  will  be 
sufficient  if  the  unbroken  packages  are  so  distributed  as  to  be  fairly  ex- 
posed to  the  action  of  the  disinfecting  agent.  To  accomplish  this,  and  to 
effectually  disinfect  the  ship,  it  will  be  necessary  to  discharge  the  cargo 
at  the  quarantine  station. 

The  collections  of  the  rag-man  cannot  properly  be  placed  in  the  same 
category  with  other  merchandise,  such  as  agricultural  products,  hard- 
ware, new  cotton  or  woollen  goods,  etc.  An  exception  with  regard  to 
rags  is  indicated,  but  not  stated  with  sufficient  precision,  in  the  article 
which  we  have  quoted.  There  is  evidence  that  small-pox  has  been  not 
infrequently  transmitted  by  rags,  and  sanitarians  are  generally  agreed 
that  it  would  be  very  imprudent  to  admit  rags  collected  in  or  shipped 
from  localities  infected  with  cholera  or  yellow  fever,  without  first  sub- 
jecting them  to  thorough  disinfection.  The  only  practical  way  of  accom- 
plishing this  seems  to  be  by  means  of  super-heated  steam.  To  make 
this  effective,  it  will  be  necessary  to  open  the  bales,  and  spread  out  the 
rags  in  such  a  manner  that  they  may  be  freely  exposed  to  the  action  of 
the  disinfecting  agent,  or  to  inject  the  steam  under  pressure  into  the  inte- 
rior of  the  bale  through  perforated  metal  tubes,  as  is  practised  at  the  New 
York  quarantine  station. 


124  PROPHYLAXIS  AGAINST  INFECTIOUS  DISEASES. 

PART  SECOND. 

INDIVIDUAL    PROPHYLAXIS    AGAINST    INFECTIOUS    DISEASES. 

The  state  establishes  quarantine  stations,  to  guard  against  the  introduc- 
tion of  infectious  diseases  of  exotic  origin  ;  and  in  enlightened  countries, 
sanitary  officials,  under  the  direction  of  the  central  government,  or  of 
states  and  municipalities,  are  charged  with  the  duty  of  guarding  the  pub- 
lic against  such  diseases.  It  is  generally  recognized  that  this  is  to  be 
accomplished  by  the  isolation  of  the  sick,  the  use  of  disinfectants,  and  by 
general  measures  of  sanitary  police. 

One  way  in  which  the  individual  may  indirectly  protect  himself  against 
such  diseases  is  by  using  his  influence  to  have  this  sanitary  service  placed 
in  the  hands  of  competent  men,  and  in  sustaining  them  in  their  efforts  to 
exclude  or  stamp  out  infectious  diseases  by  such  measures  as  have  been 
demonstrated  by  science  and  experience  to  be  efficient  for  this  purpose. 

But  this  is  not  the  kind  of  "  individual  prophylaxis"  which  we  have 
to  consider  here.  The  question  is.  What  can  the  individual  do  to  pro- 
tect himself  and  those  immediately  dependent  upon  him,  under  the  vari- 
ous circumstances  in  which  he  may  be  placed,  and  especially  in  the  pres- 
ence of  an  epidemic.'' 

As  the  advice  we  have  to  give  will  differ  greatly  according  to  the  dis- 
ease, we  shall  pass  in  review  the  principal  infectious  maladies  of  man, 
and  shall  attempt  to  give  for  each  such  practical  instructions  as  will  ena- 
ble an  intelligent  person  to  take  all  practicable  precautions  for  his  own 
protection,  and  for  that  of  his  immediate  family.  We  have  first,  how- 
ever, to  make  some  general  remarks. 

Infectious  diseases  are  contracted  by  contact  with  the  sick,  through 
the  medium  of  infected  articles, — "  fomites," — or  by  exposure  in  infected 
localities. 

The  evident  general  rule  of  prophylaxis  is,  therefore,  to  avoid  all  of 
these  sources  of  infection  ;  but  there  are  circumstances  in  which  this  is 
either  impossible  or  unjustifiable.  Duty  calls  the  physician  and  the 
nurse  into  the  sick-room,  and  no  argument  based  upon  self-protection 
can  keep  the  devoted  mother  from  the  bedside  of  her  sick  child,  or  the 
wife  from  giving  her  personal  attention  to  her  husband,  or  the  husband 
to  his  wife,  when  stricken  by  pestilence.  Humanity  requires  that  during 
an  epidemic  the  sick  shall  be  cared  for,  the  dead  buried,  and  the  foul  places 
cleansed.  All  this  calls  for  the  active  and  intelligent  efforts  of  persons 
who  have  the  courage  to  face  danger,  and  not  only  of  those  who  by  their 
profession  are  necessarily  brought  in  contact  with  the  sick, — physi- 
cians, clergymen,  sanitary  officials,  nurses, — but  often,  also,  of  volun- 
teers ;  for,  during  the  prevalence  of  an  epidemic  of  cholera,  or  of  yellow 
fever,  the  number  of  physicians  and  trained  nurses  within  the  infected 
area  is  commonly  insufficient  for  the  care  of  the  sick. 

The  history  of  epidemics  shows  that  brave  men  and  women  are  to  be 


PROPHYLAXIS  AGAINST  INFECTIOUS  DISEASES.  1 25 

found  in  every  civilized  country,  who  are  willing  to  volunteer  for  such 
perilous  duties  ;  and  also  that  physicians,  and  those  whose  legitimate  duty 
it  is  to  care  for  the  sick,  very  rarely  desert  their  post  in  time  of  danger  ; 
but  the  mortality  among  these  brave  men  and  women  who  stand  by  their 
guns,  and  among  the  volunteers  v\^ho  go  to  their  assistance,  is  often  very 
great.  There  is  a  wide-spread  notion  among  people  not  familiar  with 
the  facts,  that  doctors  enjoy  a  certain  immunity  from  infectious  diseases 
not  possessed  by  other  people,  and  that  the  absence  of  fear  is  a  safeguard 
against  infection.  Such  a  supposition  is  without  foundation,  and  is  an 
insult  to  the  brave  men  and  women  who  fall  at  their  post  of  duty  in  every 
epidemic.  Courage  is  no  more  a  protection  against  disease  germs  than 
against  bullets.  It  is  true,  that  in  epidemics,  as  in  war,  the  skulkers  and 
cowards  often  run  into  danger  which  the  men  in  the  ranks  escape.  The 
rashness  which  results  from  ignorance  or  from  thoughtlessness  is  not 
courage,  any  more  than  the  prudence  which  avoids  danger  when  there  is 
no  good  reason  for  facing  it  is  cowardice.  Those  who  rashly  venture 
within  the  lines  drawn  by  an  epidemic,  in  the  pursuit  of  business  or 
pleasure,  on  the  supposition  that  they  will  escape  the  prevailing  disease 
because  they  are  "not  afraid,"  often  fall  victims  to  their  unreasoning 
temerity,  and  not  infrequently  beat  a  hasty  retreat,  with  blanched  face, 
when  they  are  brought  directly  into  the  presence  of  the  sick  and  the  dying. 

Our  advice  to  the  brave  is.  Do  not  put  your  trust  in  your  courage,  for 
it  is  no  armor  against  infection.  Rely  rather  upon  those  precautions 
which  science  and  experience  indicate  as  best  suited  to  the  special  cir- 
cumstances in  which  you  may  be  placed,  and  do  not  hesitate  to  retreat 
before  an  invisible  foe,  when  you  are  not  required  by  considerations  of 
duty  to  remain  upon  the  field  of  battle.  If  your  services  are  not  required, 
you  are  simply  in  the  way  ;  and  if  you  fall  ill,  you  add  to  the  labors  of 
those  who  devote  themselves  to  the  care  of  the  sick.  And  to  the  timid 
we  would  say.  Let  not  your  fear  control  your  actions,  but  look  the  cir- 
cumstances fairly  in  the  face,  and  be  guided  by  reason  and  knowledge, 
or  by  the  advice  of  those  competent  to  decide  for  you.  A  premature 
flight  may  bring  you  into  ridicule,  or  into  greater  dangers  than  those  you 
flee  from.  Do  not  let  your  fears  exaggerate  the  facts,  and  weigh  these 
in  the  balance  of  your  reason,  and  not  of  your  apprehensions.  The  fact 
that  Judge  A  or  Col.  B  has  fallen  a  victim  to  cholera  or  yellow  fever  is 
no  more  a  reason  for  deserting  your  home,  than  is  the  fact  that  the  hum- 
blest citizen  of  your  town  has  died  from  the  same  disease. 

If  courage  is  no  protection  against  infection,  it  cannot  be  denied  that 
fear,  in  the  presence  of  the  infectious  agent,  is  a  predisposing  cause  which 
frequently  determines  an  attack,  and  which  may  turn  the  balance  in 
favor  of  a  fatal  result.  The  depressing  effect  of  fear  is  well  known,  and 
all  influences  which  reduce  the  vital  resisting  power  of  the  individual 
predispose  to  an  attack  when  an  epidemic  is  prevailing. 

Other  predisposing  causes  of  a  general  nature  are  those  conditions  of 
enfeebled  resistance  which  result  from  ill-health,  venereal  and  bacchana- 
lian excesses,  etc. 


126  PROPHYLAXIS  AGAINST  INFECTIOUS  DISEASES. 

Of  all  these,  it  is  probable  that  excessive  indulgence  in  intoxicating- 
drinks  is  the  most  potent  factor  in  swelling  the  mortality  returns  during 
the  prevalence  of  pestilential  diseases.  This  predisposing  cause  acts  in 
several  different  ways.  The  individual  whose  reason  is  befuddled  by 
drink,  stumbles  stupidly  Into  all  kinds  of  danger.  He  is  "not  afraid" 
to  sleep  upon  the  ground,  exposed  to  the  night  air,  when  yellow  fever  is 
prevailing,  or  to  quench  his  thirst  with  water  which  a  prudent  man 
would  reject  as  unfit  to  drink  in  the  presence  of  cholera,  or  to  wrap  him- 
self in  a  blanket  which  has  recently  been  in  use  by  a  patient  with  small- 
pox. Again:  the  debility,  often  attended  with  digestive  derangement, 
which  follows  a  recent  debauch,  constitutes  a  most  favorable  condition 
for  the  reception  of  the  germs  of  cholera,  of  yellow  fever,  and  of  infec- 
tious diseases  generally.  Those  who  use  intoxicating  drinks  habitually, 
but  within  the  limits  marked  by  that  mental  aberration  or  loss  of  reason 
which  constitutes  intoxication,  are  less  subject  to  infection  than  the  man 
who  is  suflering  from  the  effects  of  a  recent  "  spree."  But  if  they  have 
any  organic  disease  of  the  stomach,  the  kidneys,  or  the  liver,  as  a  result 
of  their  habits,  this  constitutes  a  predisposition  to  be  attacked,  and  is  a 
very  serious  complication  when  an  attack  is  developed. 

Persons  suffering  from  chronic  wasting  diseases,  profuse  discharges,  or 
recent  hemorrhage,  are  especially  liable  to  become  the  victims  of  an  in- 
fectious disease  during  its  epidemic  prevalence.  The  same  is  true  of 
those  whose  vital  resistance  is  below  par  from  insufficient  food,  or  from 
the  continued  respiration  of  vitiated  air,  crowd  poisoning,  sewer-gas 
poisoning,  etc. 

In  addition  to  the  predisposing  causes  mentioned,  which  furnish  indi- 
cations of  more  or  less  value  with  reference  to  individual  prophylaxis, 
there  are  individual  and  race  differences  in  susceptibility  to  certain  dis- 
eases manifested  by  those  who  are  in  perfect  health.  One  man  may  be 
repeatedly  exposed  to  an  infectious  disease  without  falling  sick,  while 
another  may  suffer  several  attacks  of  a  disease,  such  as  small-pox,  in 
which  one  attack  commonly  confers  immunity.  Race  differences  in  sus- 
ceptibility are  shown  in  the  relative  immunity  of  the  negro  from  the 
effects  of  the  yellow  fever  poison,  and  the  great  susceptibility  of  the  same 
race  to  small-pox. 

We  shall  now  consider  in  detail  the  question  of  individual  prophylaxis 
against  certain  infectious  diseases,  which,  by  reason  of  their  fatality  and 
occasional  wide-spread  epidemic  prevalence,  seem  entitled  to  special 
attention  in  an  essay  of  this  nature. 

Cholera.  In  Asiatic  cholera  the  danger  of  infection  from  association 
with  the  sick,  in  the  capacity  of  nurse  or  physician,  is  very  slight.  This 
is  amply  demonstrated  by  experience.  On  the  other  hand,  laundresses, 
who  do  not  come  directly  in  contact  with  the  sick,  but  who  handle  cloth- 
ing soiled  by  their  discharges,  are  liable  to  contract  the  disease.  By  far 
the  greater  number  of  cases,  however,  result  from  exposure  in  infected 
localities,  and  from  drinking  infected  water.  Outside  of  the  area  in  India 
where  cholera  prevails  as  an  endemic  disease,  localities  become  infected 


PROPHYLAXIS  AGAINST  INFECTIOUS  DISEASES.  12/ 

and  the  water-supply  contaminated  as  a  result  of  the  introduction  of 
infectious  material  from  previously  infected  localities,  either  in  fomites, 
or  through  the  medium  of  the  discharges  of  the  sick.  These  facts  fur- 
nish the  indications  for  individtial  as  well  as  for  general  measures  of 
prophylaxis. 

In  the  sick-room  the  precautions  to  be  taken  are,  to  keep  the  room 
clean  and  well  ventilated,  to  disinfect  the  discharges  of  the  sick  and  all 
soiled  articles  as  promptly  as  possible,  and  to  wash  the  hands  in  a  disin- 
fecting solution  when  they  have  been  in  contact  with  the  patient  or  with 
soiled  clothing.  Attendants  should  not  take  their  food  in  the  room  occu- 
pied by  the  sick,  and  should  not  drink  liquids  which  have  been  exposed 
in  the  sick-room. 

The  general  directions  relating  to  diet,  drinking-water,  etc.,  which  we 
shall  shortly  give,  apply  to  the  attendants  upon  the  sick,  as  well  as  to 
those  at  a  distance  from  them  ;  and  it  should  be  remembered,  in  the 
interest  of  the  sick,  that  these  attendants  do  not  run  any  special  risks 
beyond  those  to  which  all  persons  within  the  area  of  infection  are  ex- 
posed. Indeed,  we  may  go  further,  and  say  that  they  run  far  less  risk 
when  they  are  in  a  well  regulated  hospital  and  under  intelligent  supervi- 
sion, than  do  those  persons  who  dwell  in  the  localities  outside  of  the  hos- 
pital from  which  the  cases  under  their  charge  have  come. 

Attendants  upon  the  sick  should  have  their  meals  at  regular  hours, 
should  not  be  deprived  of  a  fair  allowance  of  sleep,  and  should  never  be 
allowed  to  become  exhausted  by  protracted  vigils  or  excessive  fatigue. 

When  cholera  has  been  introduced  into  a  country  and  is  extending  its 
limits  from  day  to  day,  one  of  the  first  questions  which  will  present  itself 
to  those  who  are  able  to  change  their  place  of  residence  will  be,  whether 
they  shall  attempt  to  keep  out  of  its  way,  and  if  so,  where  it  is  best  to  go. 
The  answer  to  this  question  must  depend  very  much  upon  circumstances. 
Those  who  are  unfortunate  enough  to  live  in  a  city  or  town  which  has 
a  bad  sanitary  record,  which  is  not  provided  with  an  efficient  health 
department,  or  does  not  provide  money  to  enable  the  officers  appointed 
to  do  efficient  work,  had  better  decamp  in  good  time,  so  as  to  evade  the 
foe  entirely,  or  to  meet  it  upon  a  field  more  favorable  for  defensive  opera- 
tions. There  should  be  no  stampede,  and  no  running  away  in  haste, 
without  any  definite  idea  of  why  and  where.  The  time  to  go  is  before 
the  disease  has  fairly  obtained  a  lodgment.  Consider  that  if  the  season 
is  not  far  advanced,  and  the  town  is  in  an  unfavorable  sanitary  condition, 
there  is  every  reason  to  anticipate  that  the  first  cases  will  be  followed  by 
a  severe  epidemic,  and  decide  at  the  outset  whether  you  will  put  your 
castle  in  order  to  stand  a  siege,  trusting  to  well  considered  measures 
of  individual  prophylaxis,  or  whether  you  will  beat  a  masterly  retreat  in 
advance  of  the  first  assaults  of  the  enemy.  Those  who  vacillate  in  the 
hope  one  day  that  the  epidemic  is  on  the  decline,  and  in  the  fear  the 
next  that  it  will  sweep  everything  before  it,  in  the  end  very  often  stay, 
when  they  could  just  as  well  have  gone,  and  at  the  same  time  neglect 
those  precautions  which  they  should  have  taken  at  the  outset  if  they  had 
decided  to  stay. 


128  PROPHYLAXIS  AGAIXST  INFECTIOUS  DISEASES. 

To  those  who  are  unable  or  unwilling  to  desert  their  homes,  we  would 
say,  that  when  proper  precautions  are  taken  the  danger  is  really  not  very 
great,  and  that  sanitarians  look  for  the  day  when  cholera  will  be  practi- 
cally banished  from  civilized  countries.  See  that  3^our  premises  are  in 
good  sanitary  condition,  and  do  vs^hat  you  can  to  induce  your  neighbors 
and  the  authorities  in  your  town  to  prepare  for  the  storm.  Look  espe- 
cially after  the  plumbing  of  your  houses,  and  if  there  is  a  cesspool  or  a 
priv}'-  vault  upon  your  premises,  see  that  it  is  kept  in  good  condition  by 
the  use  of  antiseptics  and  deodorants.^  Above  all,  be  sure  that  no  food 
comes  into  your  house  except  such  as  is  sound  and  good,  and  that  the 
drinking-water  used  by  your  family  is  beyond  suspicion.  Well-water  is 
always  open  to  suspicion,  and  in  general,  during  the  prevalence  of  chol- 
era, it  will  be  advisable  to  boil  all  water  used  for  drinking  purposes. 
This  is  a  prophylactic  measure  of  prime  importance,  and  there  is  good 
reason  to  believe  that  if  faithfully  executed  it  would,  to  a  great  extent, 
limit  the  ravages  of  the  Asiatic  pestilence.  Tea  and  coffee  recently  made 
can  be  taken  with  impunit}'.  Milk,  during  the  prevalence  of  an  epidemic, 
should  be  boiled  before  it  is  used  as  food.  Mineral  waters,  if  bottled  at 
places  distant  from  the  infected  area,  may  be  drunk  in  moderation.  A 
moderate  amount  of  sound  -wine,  which  was  bottled  prior  to  the  epi- 
demic, may  be  permitted  to  those  who  are  in  the  habit  of  using  it. 
Those  not  in  the  habit  of  using  stimulants  should  not  resort  to  their  use 
during  the  progress  of  an  epidemic.  Those  accustomed  to  them  should 
restrict  their  libations  within  moderate  limits,  and  will  find  a  little  brandy 
and  soda,  or  Appolinaris  water,  to  be  better  than  wines,  and  especially 
than  the  acid  wines,  which  are  apt  to  derange  the  digestion. 

Food  should  be  plain  and  well  cooked,  and  should  be  taken  in  moder- 
ate quantities.  Intemperance  in  eating  is  quite  as  bad  as  intemperance 
in  drinking.  Soups,  meats,  and  vegetables  should  always  be  served  hot, 
and  should  not  be  put  aside  for  a  future  repast,  or,  if  served  a  second  time, 
should  be  brought  to  the  temperature  of  boiling  water  shortly  before  they 
are  eaten.  Pastry  and  rich  puddings,  and  all  coarse  and  indigestible 
meats  and  vegetables,  are  to  be  avoided.  Sound,  ripe  fruit,  which  has 
been  brought  to  the  house  with  the  outer  skin  unbroken,  may  be  eaten 
in  moderation  by  those  who  know  by  experience  that  it  agrees  with  them. 
It  should  be  carefully  washed  before  it  is  eaten.  Melons,  cucumbers, 
unripe  apples,  peaches,  or  pears,  acid  fruits  generally,  and,  in  short,  all 
those  articles  which  are  known  to  give  rise  to  digestive  derangements  in 
the  absence  of  cholera,  would  better  be  banished  from  the  supply-list  dur- 
ing the  prevalence  of  this  disease . 

Next  to  the  precautions  relating  to  food  and  drink,  we  would  place 
those  relating  to  personal  habits  and  clothing.  The  bowels  should  not 
be  allowed  to  become  constipated,  and,  on  the  other  hand,  any  tendency 
to  diarrhoea  should  at  once  receive  attention.  This  is  a  matter  of  the 
greatest  importance,  and,  indeed,  is  second  to  none  other  in  individual 
prophylaxis.     Absolute  rest,  a  light  diet,  and  a  dose  or  two  of  chloro- 

*  See  Part  First  of  this  essay  for  details  relating  to  the  use  of  these  agents. 


PROPHYLAXIS  AGAINST  INFECTIOUS  DISEASES.  1 29 

dyne,  or  of  Hope's  mixture,  or  of  any  approved  combination  of  an  opiate 
and  an  astringent,  will  usually  suffice  to  control  a  slight  diarrhoea,  even  if 
it  is  of  a'tholeraic  character. 

The  clothing  should  be  suited  to  the  season,  but  great  care  must  be 
taken  that  it  is  warm  enough  at  all  times  to  prevent  the  body  from  be- 
coming chilled.  A  broad  flannel  belt  worn  about  the  abdomen  is  recom- 
mended by  some  physicians  of  experience,  and  may  be  useful.  Baths 
should  be  taken  at  frequent  intervals,  but  should  not  be  too  prolonged  or 
too  cold,  and  should  be  followed  by  a  vigorous  rubbing  of  the  surface,  to 
establish  reaction.  Excessive  exercise  and  fatiguing  labor  of  all  kinds 
are  to  be  avoided.  One  should  never  feel  "  done  up,"  as  a  result  of  his 
exertions  in  the  way  of  business  or  of  pleasure,  for  the  lassitude  resulting 
from  over-exertion,  like  that  which  results  from  fear,  predisposes  to  an 
attack.  Mental  depression  is,  so  far  as  possible,  to  be  avoided :  grief, 
despondency,  and  "  carking  care"  are  recognized  as  predisposing  causes 
in  cholera  and  in  other  infectious  diseases. 

The  use  of  "sulphuric  acid  lemonade" — that  is,  of  pure  water  acidu- 
lated with  this  acid  and  sweetened  to  taste — has  been  recommended  as  a 
prophylactic,  and  there  is  some  evidence  in  favor  of  its  usefulness.  We 
would  not  advise  its  indiscriminate  use,  or  that  of  any  other  prophylactic 
of  this  nature.  When  cholera  has  made  its  appearance  in  a  dwelling  or 
in  a  public  institution,  the  inmates  may  be  given  this,  to  the  exclusion 
of  all  other  drinks. 

Yellow  Fever.  This  disease,  like  cholera,  is  contracted  in  infected 
localities,  rather  than  by  contact  with  the  sick.  Indeed,  it  is  rarely,  if 
ever,  communicated  directly  by  a  sick  person  to  his  attendants.  In  in- 
fected places  the  poison  seems  to  be  given  off  from  the  soil,  or  from  col- 
lections of  decomposing  organic  matter,  and  we  have  no  definite  evidence 
that  it  is  communicated  through  the  medium  of  food  or  drinking-water. 
The  history  of  epidemics  of  this  disease  shows  that  when  it  obtains  a 
lodgement  in  a  city  or  town  which  is  in  an  insanitary  condition,  in  south- 
ern latitudes  and  during  the  summer  months,  it  extends  its  area  and 
invades  new  localities  similarly  situated,  until  frost  occurs,  or  at  least 
until  the  weather  becomes  comparatively  cool  in  the  autumn.  Those 
who  remain  in  an  infected  area,  unless  protected  by  a  previous  attack, 
are  almost  certain  to  contract  the  disease,  and  much  less  can  be  done  in 
the  way  of  individual  prophylaxis  than  in  cholera.  We  therefore  advise 
all  those  who  can  get  out  of  the  way  of  this  fatal  disease  to  do  so.  As  a 
rule,  there  will  be  plenty  of  time,  after  there  is  evidence  that  the  disease 
has  established  itself  in  certain  parts  of  a  city,  for  those  who  live  at  a  little 
distance  from  these  centres  of  infection  to  get  away,  in  a  deliberate  and 
well  considered  manner.  The  occurrence  of  one  or  more  imported  cases 
cannot  be  taken  as  evidence  that  an  epidemic  will  follow,  and  is  no  reason 
for  deserting  one's  home.  If  proper  precautions  are  taken  by  the  sanitary 
authorities,  it  is  very  probable  that  no  evil  result  will  follow  such  impor- 
tation of  the  disease.  But  when  these  imported  cases  are  followed  by  the 
occurrence  of  other  cases  in  the  vicinity  where  they  have  been  sick,  or 


130  PROPHYLAXIS  A  GAINST  INFECTIO  US  DISEASES. 

when  such  local  cases  occur  in  the  vicinity  of  the  wharves  where  vessels 
from  infected  ports  discharge  their  cargoes,  or  in  sailors'  boarding-houses, 
etc.,  it  must  be  taken  as  evidence  that  the  disease  has  effected  .a  lodge- 
ment, and  that  infected  centres  have  been  established,  from  which  an 
epidemic  will  in  all  probability  be  developed,  if  the  season  is  favorable 
and  the  city  in  an  insanitary  condition. 

An  epidemic  is  not  developed  so  rapidly  as  in  the  case  of  cholera,  but 
tlie  disease  usually  extends  its  limits  in  a  very  deliberate  way,  and  while 
it  is  claiming  its  victims  in  one  section  of  a  city,  other  sections  in  the  im- 
mediate vicinity  maybe  quite  healthy.  But  the  territory  invaded  remains 
infected  until  cold  weather  puts  an  end  to  the  epidemic.  Frequently  it 
happens  that  no  new  cases  occur  in  an  infected  area  for  several  weeks,  or 
even  months,  for  the  simple  reason  that  all  those  who  remained  to  do 
battle  with  the  pestilence  have  suffered  an  attack  or  are  protected  by  a 
previous  attack.  The  epidemic  has  ceased  for  want  of  material,  but  the 
infection  remains,  and  will  manifest  itself  if  unpi"otected  persons  venture 
within  the  infected  area  from  a  mistaken  idea  that  there  is  no  more  dan- 
ger because  there  are  no  longer  any  cases. 

In  this  disease,  then,  the  most  important  point  in  individual  prophylaxis 
is  to  keep  away  from  infected  localities,  and  from  those  places  where  the 
disease  is  epidemic, — e.  ^.,  Havana,  Vera  Cruz,  Rio  Janeiro, — during 
the  season  of  its  prevalence.  Very  many  lives  have  been  sacrificed  by  a 
misplaced  confidence  in  the  protection  which  courage  is  supposed  to  af- 
ford against  this  disease,  "lam  not  afraid,"  says  the  merchant  whose 
business  calls  him  to  an  infected  city,  or  the  sea-captain  who  wishes  to 
obtain  a  cargo  of  sugar  in  Havana  during  the  summer  months.  But  not 
being  afraid  does  not  prevent  such  persons  from  being  attacked,  and  the 
mortality  at  Havana  among  sailors  from  northern  latitudes  is  very  great. 
There  is  a  tendency  in  places  where  the  disease  is  endemic  to  underrate 
its  malignity,  and  to  ascribe  every  fatal  case  to  some  fault  on  the  part  of 
the  unfortunate  victim  or  his  attendants.  He  was  "  frightened  to  death," 
or  "  was  not  properly  nursed,"  or  he  was  "imprudent,"  etc.,  etc.  The 
mortality  is  no  doubt  largely  influenced  by  these  secondary  causes,  but 
yellow  fever  is  a  malignant  disease,  which  under  the  most  favorable  cir- 
cumstances is  very  fatal  to  unacclimated  strangers  within  the  limits  of  its 
endemic  prevalence,  and  which  in  its  epidemic  extension  in  new  territory 
claims  from  30  to  50  per  cent.,  or  even  more,  of  those  who  fall  sick,  as  its 
victims.  This  being  the  case,  we  repeat  our  advice  to  all  those  whose 
duty  does  not  require  them  to  stay  on  the  field  of  battle,  to  make  an  or- 
derly retreat  to  some  place  of  safety. 

The  precautions  relating  to  food  and  to  personal  habits  do  not  differ 
materially  from  those  recommended  in  the  case  of  cholera.  The  diet 
should  be  simple,  and  excesses  should  be  avoided.  Less  care  will  be 
necessary  with  reference  to  the  use  of  fruits  and  vegetables  ; — indeed,  they 
are  rather  to  be  recommended,  as  better  suited  than  animal  food  to  the 
warm  latitudes  in  which  this  disease  prevails.  Constipation  should, 
above  all  things,  be  avoided  ;  and  if  there  is  evidence  that  the  functions 


PROPHYLAXIS  A  GAINST  INFECTIO  US  DISEASES.  1 3 1 

of  the  liver  or  kidneys  are  imperfectly  performed,  suitable  medication 
should  be  resorted  to. 

There  is  no  special  danger  from  the  use  of  water,  if  it  is  from  a  source 
which  ensures  it  from  contamination  with  organic  impurities.  Spirituous 
liquors,  if  used  at  all,  should  be  taken  in  great  moderation.  Nothing  is 
more  likely  to  develop  an  attack  than  alcoholic  excesses,  and  the  habitual 
drunkard  is  almost  doomed  to  death  if  he  falls  sick  with  this  disease. 
Exposure  to  the  direct  rays  of  the  sun,  excessive  fatigue,  and  venereal  ex- 
cesses are  all  predisposing  causes  which  it  is  within  the  province  of  in- 
dividual prophylaxis  to  avoid.  Exposure  to  the  night  air,  and  especially 
sleeping  out  of  doors  near  the  ground,  is  recognized  by  experienced 
physicians  in  yellow  fever  regions  as  an  invitation  to  an  attack.  Great 
care  should  be  taken  to  avoid  chilling  of  the  body,  and  it  is  well  to  sleep 
as  far  from  the  ground  as  possible.  The  Creoles  of  Louisiana  and  of  the 
West  Indies  generally  insist  upon  closing  the  windows  of  a  sleeping-room 
at  night. 

The  mortality  among  natives  of  tropical  climates,  and  especially 
among  those  whose  habits  are  good,  and  who  are  accustomed  to  a  frugal 
mode  of  life,  is  very  much  less  than  among  the  natives  of  northern  lati- 
tudes, when  these  come,  without  any  previous  "  acclimation,"  within  the 
influence  of  the  yellow  fever  poison.  Those  who  are  habituated  to  life 
in  the  extreme  South  enjoy  a  certain  immunity  from  the  effects  of  the 
poison,  which  is  shown  by  a  lower  death-rate  rather  than  by  any  exemp- 
tion from  being  attacked.  One  attack  of  this  disease,  as  a  rule,  confers 
immunity  from  a  subsequent  attack. 

Individual  prophylaxis  in  an  infected  city  will  include  the  avoidance  of 
those  localities  which  give  special  evidence  of  being  infected,  and  espe- 
cial care  not  to  visit  such  localities  at  night. 

The  liberal  use  of  disinfectants  in  cesspools  and  water-closets,  and  a 
perfect  state  of  sanitary  police  in  and  around  the  premises,  will  constitute 
a  most  important  part  of  the  precautionary  measures  which  every  individ- 
ual should  take  for  his  own  protection  and  that  of  his  family.  A  state 
of  mental  equilibrium,  and  an  intelligent  appreciation  of  the  special  cir- 
cumstances in  which  he  is  placed,  and  of  the  various  measures  of  pro- 
phylaxis heretofore  indicated,  will  enable  an  individual  to  look  the  facts 
fairly  in  the  face,  and  to  be  governed  by  the  light  of  reason  and  of  science. 
Unfortunately  it  too  often  happens,  among  the  ignorant  and  degraded, 
that  a  spirit  of  bravado,  attended  with  a  neglect  of  the  simplest  sanitary 
precautions,  and  a  disposition  to  deny  the  presence  of  the  dreaded  foe, 
prevails  during  the  earlier  stages  of  an  epidemic,  and  that  this  is  followed 
by  a  disorderly  stampede  and  a  disgraceful  neglect  of  the  sick,  when  the 
presence  and  malignant  nature  of  the  pestilence  are  recognized. 

Small-Pox.  This  disease  is  contracted  by  exposure  to  emanations 
from  the  body  of  the  sick,  or  from  articles  which  have  been  in  use  by 
them,  or  exposed  in  their  vicinity.  There  is  no  evidence  that  the  small- 
pox poison  multiplies  external  to  the  human  body,  and  the  indications 
for  prophylaxis  are  therefore  quite  different  from  those  already  given  for 


1 3  2  PROPHYLAXIS  A  GAINST  INFECTIO  US  DISEASES. 

cholera  and  yellow  fever.  One  may  eat  what  he  pleases,  and  wallow  in 
filth,  when  small-pox  is  prevailing,  without  contracting  the  disease,  so 
long  as  he  keeps  away  from  the  sick,  and  is  not  brought  in  contact  with 
any  article  infected  by  them.  In  this  disease,  however,  as  in  the  infec- 
tious diseases  generally,  previous  personal  habits  will  greatly  influence 
the  result  when  exposure  does  occur  ;  and  the  disease  is  more  fatal  to  the 
victims  of  alcoholism,  to  those  who  are  poorly  nourished,  and,  in  gen- 
eral, to  those  whose  vitality  is  reduced  by  exposure  to  noxious  effluvia 
from  putrefying  material,  by  living  in  overcrowded  and  ill-ventilated 
apartments,  etc. 

As  it  is  now  the  universal  practice  to  isolate  small-pox  patients  as  soon 
as  the  disease  is  recognized,  the  danger  of  coming,  accidentally,  in  con- 
tact with  them  is  not  great.  There  is  but  little  danger  of  infection  from 
passing  within  a  few  yards  of  a  patient  with  small-pox  in  the  open  air,  or 
from  passing  a  building  in  -which  cases  are  under  treatment.  Unprotected 
persons  who  enter  the  sick-room  are,  however,  extremely  liable  to  contract 
the  disease  ;  and  the  infectious  material  given  off"  from  the  patient's  body 
clings  most  tenaciously  to  surfaces,  to  clothing,  etc.,  and  may  give  rise 
to  an  attack  after  many  months,  unless  destroyed  by  disinfection. 

It  is  evident,  then,  that  individual  prophylaxis  will  include  the  avoid- 
ance of  places  which  have  been  occupied  by  the  sick,  and  of  articles  used 
by  them,  unless  there  is  a  certainty  that  they  have  been  thoroughly  disin- 
fected. It  is  probable  that  an  unprotected  person,  who  feels  obliged,  for 
special  reasons,  to  enter  the  sick-room,  may  escape  infection  by  the  use 
of  an  air  filter  placed  over  the  mouth  and  nostrils.  This  should  be  con- 
structed on  the  principle  of  the  "  Tyndal  respirator,"  in  which  all  inspired 
air  is  made  to  pass  through  a  layer  of  cotton  wadding,  which  arrests  sus- 
pended particles.  It  would  be  necessary  immediately  on  coming  out  of 
the  room  to  burn  the  cotton  filter,  to  bathe  the  hands  and  face  in  a  disin- 
fecting solution,  and  to  change  the  outer  clothing. 

It  is  a  general  rule  in  regard  to  infectious  diseases  that  those  who  are 
necessarily  exposed  to  them  should  take  the  precaution  of  not  going  into 
the  sick-room  with  an  "  empty  stomach,"  or  in  a  condition  of  exhaustion 
from  any  cause.  A  cup  of  coffee,  or  a  glass  of  wine  and  a  cracker,  may 
be  taken  if  a  considerable  interval  has  elapsed  since  the  last  regular  meal. 

It  is  well  known  that  against  small-pox  we  have  a  special  measure  of 
prophylaxis,  which  has  restricted  the  ravages  of  this  disease  within  the 
limits  which  are  left  to  it  by  carelessness  in  regard  to  the  application  of 
this  measure,  or  ignorance  of  its  value.  Since  the  famous  discovery  by 
Jenner,  vaccination  has  become  the  prophylactic  par  excellence. 

The  immunity  conferred  by  vaccination  is,  as  a  rule,  complete  ;  but 
there  are  exceptions  to  this  rule,  and  vaccinated  persons  occasionally 
suffer  from  a  modified  form  of  the  disease.  The  statistics  of  the  London 
small-pox  hospital  show  that  the  mortality  among  unvaccinated  persons 
received  into  that  hospital  with  small-pox,  is  35.55  per  cent.  ;  while  the 
mortality  among  vaccinated  persons  is  less  than  7  per  cent.  No  doubt  a 
large  portion  of  the  cases  of  post-vaccinal  small-pox  might  have  been 
prevented  by  revaccination. 


PROPHYLAXIS  AGAINST  INFECTIOUS  DISEASES.  I33 

It  is  now  recognized  that  the  protective  influence  of  vaccination  is  not 
always  of  a  permanent  character,  and  children  who  have  been  success- 
fully vaccinated  in  infancy  should  be  revaccinated  when  they  reach  the 
age  of  puberty,  or  sooner,  if  small-pox  is  prevailing  in  the  neighborhood. 
The  operation  is  so  trifling  that  it  is  customary  to  vaccinate  old  and 
young,  with  the  exception  of  those  who  have  been  successfully  vaccinat- 
ed within  a  year  or  two,  whenever  an  outbreak  of  small-pox  occurs. 
This  practice  is  to  be  recommended,  but  when  the  operation  has  been 
performed  in  a  proper  manner,  with  virus  which  is  known  to  be  reliable, 
it  is  folly  to  insist  upon  a  frequent  repetition  of  the  vaccination,  because 
"  it  didn't  take."  If  the  first  vaccination  has  been  completely  successful, 
a  perfect  result  from  revaccination  is  not  usually  obtained  ;  and  the  fact 
that  no  result  is  obtained  must  be  taken  as  evidence  that  the  person  is 
protected.  The  prophylactic  value  of  vaccination  practised  after  expos- 
ure to  small-pox  has  been  demonstrated,  and  one  who  is  not  entirely  cer- 
tain that  he  is  protected  by  a  recent  successful  vaccination  will  do  well 
to  resort  to  this  important  prophylactic  measure  at  once,  if  he  has  reason 
to  suspect  that  he  has  been  exposed  to  small-pox. 

Scarlet  Fever.  In  this  disease,  as  in  small-pox,  the  poison  is  given 
off*  from  the  bodies  of  the  sick,  and  is  not  reproduced  independently  of 
them.  As  we  have  no  knowledge  of  any  means  of  protection  corre- 
sponding with  vaccination,  prophylaxis  consists  solely  in  keeping  out  of 
the  reach  of  infection  by  the  sick,  or  by  articles  infected  by  them. 

The  sick  person  may  communicate  the  disease  during  the  whole  period 
of  his  illness  and  convalescence, — a  period  which  often  extends  to  five  or 
six  weeks,  or  even  longer  than  this.  Infected  clothing,  which  has  been 
packed  away  for  months,  may  communicate  the  disease  ;  and  there  are 
numerous  instances  on  record  of  its  transmission  to  children  at  a  distance 
from  the  sick,  by  healthy  persons  who  have  recently  come  in  contact 
with  scarlet  fever  patients.  The  lower  animals,  and  especially  pet  cats 
and  dogs  which  may  have  visited  the  sick-room  unnoticed,  or  which  are 
thoughtlessly  given  to  convalescent  children  for  their  amusement,  consti- 
tute a  great  source  of  danger.  Persons  who  have  suffered  an  attack  of 
the  disease,  or  who  have  but  little  susceptibility  to  it,  may  have  a  slight 
sore  throat  as  a  result  of  exposure  to  the  scarlet  fever  poison,  and  may 
communicate  the  disease  in  its  more  severe  form  to  unprotected  children. 
One  great  difficulty  in  arresting  th#  progress  of  an  epidemic  by  isolation 
of  the  sick  and  disinfection,  results  from  the  fact  that  these  slight  and 
often  unrecognized  cases  are  frequently  allowed  full  liberty. 

Infection  has  been  traced  to  milk  which  had  been  standing  in  the  sick- 
room, or  to  the  same  liquid  which  had  become  infected  at  a  dairy  where 
scarlet  fever  had  prevailed,  and  where  recent  convalescents  were  permit- 
ted to  milk  the  cows. 

All  of  these  facts  point  to  a  most  rigid  exclusion  of  susceptible  children 
from  every  possible  source  of  infection.  The  susceptibility  of  adults  is 
very  much  less,  and,  when  attacked,  they  usually  have  the  disease  in  a 
mild  form.     But  their   responsibility   extends  far  beyond  the  point  of 


1 34  PROPHYLAXIS  A  GAINST  INFECTIO  US  DISEASES. 

avoiding  the  sick  for  their  own  protection.  Those  who  are  associated 
with  susceptible  children  have  no  right  under  any  circumstances  to  visit 
the  room  of  a  scarlet  fever  patient  without  taking  the  most  thorough  pre- 
cautions with  regard  to  the  disinfection  of  their  person  and  clothing 
immediately  upon  leaving  it ;  and  even  with  these  precautions,  such  a 
visit  cannot  be  justified  when  it  is  made  simply  out  of  curiosity  or  friend- 
ship. Only  those  who  are  in  attendance  upon  the  sick  should  be  allowed 
in  the  sick-room,  and  they  must  be  regarded  as  iafected  persons,  who  are 
not  to  be  permitted  to  come  in  contact  with  unprotected  children  while 
they  are  engaged  in  this  duty. 

Diphtheria.  This  is  a  disease  in  which  the  infectious  material  is 
given  oflf  from  the  surfaces  affected,  and  probably  not  from  the  general 
surface  of  the  body.  As  the  usual  seat  of  the  disease  is  the  throat  and 
the  nasal  mucous  membrane,  it  is  the  discharges  from  these  surfaces 
which  are  especially  dangerous.  Although  adults  are  much  less  suscep- 
tible to  the  disease  than  children,  there  have  been  numerous  instances  in. 
which  they  have  contracted  diphtheria  by  the  accidental  reception  of  a 
bit  of  infectious  material  directly  into  the  fauces.  This  is  especially  lia- 
ble to  occur  during  the  operation  of  tracheotomy  ;  and  several  physicians 
have  lost  their  lives  in  this  way,  in  their  efforts  to  save  those  of  their  pa- 
tients by  aspirating  through  the  tracheotomy  tube.  It  seems  extremely 
probable  that  the  diphtheretic  poison — germ — is  capable  of  increase, 
independently  of  the  sick,  in  damp,  foul  places,  such  as  sewers,  damp 
cellars,  and  especially  under  old  houses  in  which  the  floors  come  near 
the  surface  of  the  ground,  leaving  a  damp,  ill-ventilated  space.  At  all 
events,  the  disease  often  clings  to  such  houses  in  spite  of  the  application 
of  the  usual  means  of  disinfection.  There  is  no  doubt  as  to  the  influence 
of  bad  hygienic  conditions  in  maintaining  the  infection  when  the  disease 
has  been  introduced,  and  it  is  possible  that  such  conditions  may,  in  cer- 
tain cases,  originate  it. 

InsufiScient  nourishment,  the  malarial  poison,  and  insanitary  surround- 
ings are  predisposing  causes  to  the  disease.  Those  suffering  from  scar- 
let fever,  measles,  whooping-cough,  and  tuberculosis  are  also  especially 
liable  to  be  attacked.  As  in  the  case  of  scarlet  fever,  mild  cases,  which 
in  the  absence  of  others  more  pronounced  it  would  be  difficult  to  recog- 
nize as  due  to  the  diphtheretic  poison,  may  give  rise  to  malignant  diph- 
theria in  more  susceptible  individuate,  or  in  those  whose  vital  resisting 
power  is  reduced  by  any  of  the  causes  mentioned. 

Prophylaxis  will  demand  complete  non-intercourse  with  the  sick, 
avoidance  of  infected  localities,  and  care  to  exclude  all  persons  and  arti- 
cles coming  from  such  houses  from  contact  with  yourself  or  children. 
The  disease  is  often  spread  by  thoughtless  persons  who  visit  the  sick- 
room, and  even  kiss  the  infected  patients,  and  then,  without  any  precau- 
tions in  the  way  of  disinfection,  fondle  healthy  children  in  other  places, 
and  perhaps  transmit  by  a  kiss  the  infectious  material  which  has  adhered 
to  their  lips.  The  possibility  of  transmission  by  pet  animals  is  also  to  be 
borne  in  mind. 


PROPHYLAXIS  AGAINST  INFECTIOUS  DISEASES.  1 35 

Ttiberculosis.  Recent  researches  have  demonstrated  that  tubercular 
consumption  is  an  infectious  disease,  and  that  the  sputa  of  those  affected 
with  it,  injected  into  susceptible  animals,  reproduces  in  them  the  same 
■disease.  This  sputum  is  therefore  infectious  material,  and  should  be 
destroyed  by  burning,  or  by  the  use  of  chemical  disinfectants.  There 
would  be  little  danger  of  infection  from  the  moist  masses  of  sputum,  but 
in  a  desiccated  condition  this  material  is  liable  to  reach  the  lungs  of  sus- 
ceptible individuals,  and  to  induce  the  disease. 

It  is  well  known  that  there  is  a  great  difference  in  susceptibility  to 
pulmonary  consumption,  and  that  in  certain  families  this  disease  carries 
off  one  member  after  another,  while  it  is  unknown  in  other  families. 
Those  who  have  this  hereditary  predisposition  should  pay  special  atten- 
tion to  individual  prophylaxis.  They  should  avoid  intimate  association 
with  consumptive  persons,  should  live  under  the  best  hygienic  conditions, 
in  dry,  well  ventilated  apartments,  and  should  select  an  occupation  which 
will  keep  them  in  the  open  air,  rather  than  one  which  keeps  them  con- 
fined to  the  house.  Above  all,  they  should  avoid  the  respiration  of  an 
atmosphere  loaded  with  organic  impurities,  or  with  irritating  inorganic 
particles — dust  of  various  kinds.  Out  of  door  life  on  the  high  and  dry 
plains  in  the  centre  of  the  continent,  or  in  the  mountains,  will  in  most 
ir.stances  enable  them  to  overcome  the  predisposition,  if  commenced 
before  infection  and  the  resulting  tubercular  lesions  have  occurred. 

Those  who  are  engaged  in  occupations  which  require  them  to  pass 
sonie  hours  each  day  in  an  atmosphere  loaded  with  dust  will  do  well  to 
wear  a  respirator  for  filtering  the  suspended  particles  from  the  air  ;  for  it 
is  demonstrated  that,  independently  of  hereditary  predisposition,  the  res- 
piration of  such  an  atmosphere  predisposes  to  tubercular  disease  of  the 
lungs 

Typhoid  Fever.  In  this  disease,  as  in  cholera,  the  infectious  agent  is 
contained  in  the  alvine  discharges  of  the  sick.  In  the  interest  of  self- 
preserration  as  well  as  in  that  of  the  public  good,  every  individual  who 
has  charge  of  cases  should  see  that  the  evacuations  from  the  bowels  are 
thoroughly  disinfected  before  they  are  thrown  out. 

The  drinking  of  water  contaminated  with  such  infectious  discharges  is 
recognized  as  a  very  frequent  mode  of  infection  ;  and  individual  prophy- 
laxis demands  an  intelligent  consideration  of  the  source  from  which  a 
supply  of  drinking-water  is  obtained  for  personal  or  family  use.  If  there 
is  the  least  reason  to  suspect  that  this  supply  may  be  contaminated  by 
typhoid  naterial,  or  if  it  contains  an  undue  amount  of  organic  impuri- 
ties, it  should  be  rejected  entirely,  or  boiled  shortly  before  it  is  used. 

Typhoid  epidemics  have  in  several  instances  been  traced  to  using  milk 
which  had  been  contaminated  by  infected  water,  added  to  it  directly,  or 
used  at  the  dairy  to  wash  the  vessels  containing  it.  The  remedy  in  this 
case  is  to  verify  the  purity  of  the  source  of  supply  of  all  milk  used  for 
drinking,  or  to  boil  it  immediately  before  it  is  used. 

The  water  of  wells  located  within  the  limits  of  a  city  or  village  should 
not,  as  a  rule,  be  used  for  drinking  purposes,  for  the  soil  is  almost  cer- 


136  PROPHYLAXIS  A  GAINST  INFECTIOUS  DISEASES. 

tain  to  be  polluted  ;  and  it  often  occurs  that  the  contents  of  privy  vaults 
and  cesspools  pass  into  the  same  porous  stratum  of  sand  or  gravel  from 
which  the  well-water  is  obtained,  or  that  surface  drainage  finds  its  way 
into  shallow  wells.  It  will  be  necessary,  also,  to  regard  with  suspicion 
the  water  of  small  streams  and  ponds  which  are  so  situated  that  they 
may  receive  the  drainage  from  collections  of  filth  upon  their  margin. 

Next  to  impure  water  we  must  place  impure  air  as  a  factor  in  the  eti- 
ology of  t}^phoid  fever.  There  is  good  reason  to  believe  that  the  germs 
of  the  disease  may  be  carried  by  the  foul  gases  which  are  given  off  from 
sewers,  privies,  etc.,  when  these  become  infected,  and  that  the  disease 
may  be  induced  by  the  respiration  of  such  a  contaminated  atmosphere. 
At  all  events,  the  breathing  of  a  vitiated  atmosphere,  and  insanitary  sur- 
roundings generally,  constitute  predisposing  causes  which  should  be 
avoided. 

In  t5'phoid  fever,  as  in  yellow  fever  and  cholera,  depressing  mental 
emotions,  such  as  grief,  despondency,  or  fear,  and  physical  exhaustion 
from  excessive  fatigue,  insufficient  food,  etc.,  are  predisposing  causes 
which  may  induce  an  attack  in  the  presence  of  the  infectious  agent. 

Concluding  remarks.  This  chapter  might  be  greatly  extended,  but, 
having  passed  in  review  the  principal  measures  of  individual  prophylaxis 
against  those  infectious  diseases  which  are  most  fatal,  we  shall  not  dwell 
upon  precautions  to  be  taken  in  other  contagious  diseases,  such  as  mea- 
sles and  whooping-cough.  These  precautions  will  not  differ  from  those 
already  recommended  in  the  cases  of  small-pox  and  scarlet  fever.  ,So, 
too,  in  regard  to  the  infectious  skin  diseases.  These  are  communig^ted 
by  personal  contact,  and  rarely  occur  except  among  those  who  n^lect 
personal  cleanliness,  as  well  as  other  sanitary  laws.  Soap  and  water 
will  generally  suffice  for  individual  prophylaxis.  By  avoiding  filthy  per- 
sons as  well  as  filthy  places,  the  danger  of  contracting  these  and  certain 
other  unmentionable  infectious  diseases  will  be  reduced  to  a  minimum. 


THE  PREVENTABLE  CAUSES  OF  DISEASE,  INJURY,  AND 
DEATH  IN  AMERICAN  MANUFACTORIES  AND  WORK- 
SHOPS, AND  THE  BEST  MEANS  AND  APPLIANCES  FOR 
PREVENTING  AND  AVOIDING  THEM. 


By  GEORGE  H.  IRELAND, 

Springfield,  Mass. 


Copyright,  l886, 
By  Irving  A.  Watson,  Sec.  American  Public  Health  Association. 


All    Rights    Reserved, 


THE  PREVENTABLE  CAUSES  OF  DISEASE,  INJURY,  AND 
DEATH  IN  AMERICAN  MANUFACTORIES  AND  WORK- 
SHOPS, AND  THE  BEST  MEANS  AND  APPLIANCES  FOR 
PREVENTING  AND  AVOIDING  THEM. 

We  are  aware  that  the  home  life  of  the  average  American  mechanic  is 
not  what  it  should  be.  In  considering  our  subject,  we  must  assume  that 
he  comes  from  a  clean  house,  well  ventilated  ;  that  he  has  a  pure  water- 
supply  ;  that  he  brings  a  well  nourished  body  ;  that  his  clothes  are  clean, 
and  duly  cared  for  ; — in  fact,  his  wife's  work  ' '  should  praise  her  in  the 
gates." 

The  location  of  the  factory  is  an  important  subject  for  the  workman. 
In  the  city  he  is  exposed  to  lung  disease  from  a  smoky  atmosphere  and 
impure  air,  bad  eyes  from  poor  light  during  the  day-time,  great  danger 
from  fire  owing  to  the  buildings'  being  huddled  together,  and  also  from 
the  combustible  nature  of  the  surroundings.  The  suburban  factory  pre- 
sents disease  in  the  shape  of  malaria  and  pulmonary  troubles,  owing  to 
the  fog  that  rises  fr-om  the  undrained  land,  and  from  fevers  from  the  bad 
or  no  sewer  connection. 

Unfortunately  the  builders  of  factories  have  not  that  latitude  of  choice 
open  to  builders  of  private  residences.  The  manufacturer  has  many  lim- 
itations, such  as  water-power,  and  proximity  to  railroads  and  other  facto- 
ries. Some,  of  strict  necessity,  must  be  carried  on  in  the  midst  of  thickly 
settled  cities.  Manufacturers  are,  however,  each  year  loosening  the  fet- 
ters that  seemingly  have  bound  them,  and  are  exercising  more  thoughtful 
care  in  the  selection  of  building  sites.  They  find  it  profitable  to  their 
pockets,  as  well  as  contributory  to  the  health  of  their  operatives,  to  erect 
their  buildings  in  moderate  sized  towns,  or  in  the  suburbs,  rather  than  in 
the  heart  of  the  great  cities  themselves. 

The  building  should  be  placed  upon  well  drained  land,  and  every  pre- 
caution should  be  taken  against  any  possible  trouble  from  surface  or  over- 
flow water.  These  remarks  apply  also  to  the  adjoining  lands,  as  land 
that  fluctuates  from  overflow  to  dry  soil  is  a  frequent  cause  of  malaria. 

The  building  should  be  of  brick,  and,  if  possible,  only  two  stories  high. 
(A  woollen  manufacturer,  who  had  the  experience  of  several  fires  in  his 
factory,  remarked  in  our  presence  "  that  were  he  to  rebuild,  he  would 
only  build  two  stories  high,  as  then,  in  case  of  fire,  the  hands  would  feel 
certain  of  their  safety,  and  make  a  stubborn  fight  to  subdue  the  flames.") 
The  floor  timbers  should  rest  on  ledges  built  in  the  walls.  The  flooring 
should  fit  closely,  affording  no  hiding-places  for  rats.  Where  noisy  occu- 
pations are  to  be  carried  on,  the  floors  are  to  be  "  deafened."     Each  story 


I40  PREVENTABLE  CAUSES  OF  DISEASE,  &=€. 

is  to  be  high  enough  to  permit  of  good  ventilation  without  the  draft  strik- 
ing on  the  heads  of  the  workmen  ;  the  roof  to  be  of  metal  or  slate  ;  stone 
coping  to  be  used  on  chimneys  and  all  walls  extending  above  the  roof: 
this  prevents  loose  bricks  from  falling.  The  cornices  should  be  of  sheet 
metal,  when  stone,  brick,  or  terra  cotta  is  not  used  ;  columns  to  be  of 
hard  wood  or  brick,  as  they  will  not  warp  if  badly  heated  ;  chimneys  to 
rest  upon  their  own  foundations,  starting  from  the  ground  ;  the  walls  to 
be  whitewashed  directly  upon  the  bricks.  If  plastering  is  required,  use 
metallic  lathing.  The  stairs,  of  easy  pitch,  are  located  at  each  end  of  the 
building.  In  long  buildings  other  flights  are  to  be  added,  so  that  no  per- 
son will  be  obliged  to  go  over  eighty  feet  to  reach  a  stairway  ;  the  stairs 
to  be  of  iron,  excepting  the  treads  and  risers,  which  may  be  of  wood. 
Where  women  are  not  employed,  omit  the  risers  ;  each  flight  to  reach 
the  stoiy  above  by  a  direct  flight,  no  turns  to  be  permitted  ;  the  top  of 
each  flight  to  be  cased  in,  and  a  door  provided  which  is  to  be  closed  each 
night,  and  after  the  exit  of  the  operatives  in  case  of  fire.  This  door  is  to 
be  of  plank  completely  covered  with  tin,  the  joints  of  which  are  turned 
over.  The  hinges  to  the  door  are  to  be  fastened  by  bolts  passing  clear 
through  the  door.  This  style  of  door  is  the  proper  one  for  inside  pur- 
poses where  one  section  of  the  building  is  divided  from  the  others.  This 
door  will  stand  where  the  ordinary  iron  door  would  be  curled  up  and 
drawn  out  of  position  by  the  heat.  A  scuttle  fastened  only  by  a  hasp  is 
to  be  placed  in  the  roof  over  each  stairway.  This  scuttle  is  reached  by  a 
flight  of  steps  always  in  position.  Elevators  and  elevator  shafts  are  the 
causes  of  many  accidents.  At  the  best  they  are  dangerous  things,  and 
need  to  be  carefully  guarded.  The  shaft  forms  a  direct  means  of  com- 
munication for  the  flames  from  the  basement  upwards  ;  it  is  ever  ready 
for  the  reception  of  any  thoughtless  person.  The  moving  cage  or  plat- 
form crushes  and  maims,  and  the  parted  rope  sends  its  precious  load  to 
the  bottom  of  the  elevator  well,  a  mangled  mass  of  humanity.  The  ele- 
vator should  have  safety  self-locking  attachments  (to  operate  in  case  of  a 
broken  suspension  rope),  self-closing  hatchways,  and  guards  at  each 
landing.  One  person  should  be  designated  to  run  each  elevator,  and  he 
should  be  held  strictly  responsible  for  its  proper  use.  Thus,  detailing 
one  person  for  this  duty  is  entirely  practicable,  even  when  the  elevator 
work  is  not  enough  to  occupy  his  time.  By  a  system  of  gong  signals,  he 
can  be  called  from  his  other  work  to  run  the  elevator  when  required.  A 
good  sized  gong-bell  is  located  in  the  elevator  well,  and  strokes  call  as 
follows  :  One,  basement ;  two,  second  floor ;  three,  third  floor ;  four, 
fourth  floor  ;  a  clanging  of  several  strokes,  an  emergency  call.  We  have 
seen  this  plan  most  satisfactorily  carried  out  for  several  years.  If  self- 
closing  hatchways  are  not  adopted,  a  sign  marked  DANGER  should  be 
suspended  by  cords  or  chains  about  five  feet  from  the  bottom  of  the  ele- 
vator :  this  gives  timely  warning  to  those  below  of  the  descent  of  the 
elevator.  Where  there  are  projecting  cross  timbers  in  the  elevator  well, 
their  corners  should  be  rounded,  in  order  that  nothing  may  be  caught 
under  tliem.     All  elevators  should  be  provided  with  automatic  shifting 


PREVENTABLE  CAUSES  OF  DISEASE,  &>€.  I41 

devices,  to  operate  in  case  the  carriage,  from  any  cause,  is  left  running. 
Ropes  and  chain  falls  should  have  a  shifting  lever  attached  to  the  beam, 
to  be  operated  by  a  projection  just  above  the  hook.  This  runs  the  driv- 
ing belt  upon  a  loose  pulley  in  case  the  w^inding  drum  is  permitted  to  go 
too  far.  Proprietors  should  insist  that  all  elevator  operators,  and  all  who 
ride  vl^ow. freight  elevators,  maintain  the  standing  posture,  as  then  they 
are  in  position  to  use  all  their  faculties  in  case  of  accident.  It  should,  if 
possible,  be  a  rule,  upon  all  freight  elevators,  that  only  the  operator  ride. 
Many  accidents  are  the  direct  result  of  ' '  fooling"  upon  the  slow  freight 
elevators,  where  all  are  allowed  to  ride.  In  a  factory  with  which  we  are 
acquainted,  they  have  a  very  slow  freight  elevator,  taking  some  two  min- 
utes to  cover  five  stories.  One  warm  day,  the  operator,  having  to  go  empty 
from  the  basement  to  the  top  store  room,  laid  down  upon  the  elevator 
platform.  His  head  by  some  means  came  in  contact  with  a  timber :  he 
w^ould  have  been  killed  had  not  his  cries  quickly  attracted  the  attention 
of  one  of  the  foremen,  who  stopped  the  elevator.  As  it  was,  his  scalp 
hung  over  his  face,  being  held  only  by  a  hinge  at  the  forehead.  Had  he 
been  standing  upright,  the  accident  could  not  have  happened. 

The  annual  loss  of  life  in  attempting  to  escape  from  burning  factories 
is  appalling,  and  the  subject  of  fire-escapes  demands  the  most  serious 
consideration.  Fire-escapes  are  of  many  forms.  The  best  ones  for  gen- 
eral use,  and  the  only  kind  that  can  be  relied  upon  where  women  are 
employed,  is  the  zig-zag  iron  stair  system  of  ladders  yR\\hJlat  treads,  the 
whole  to  be  of  iron  firmly  secured  to  the  outside  of  the  building,  and  ex- 
tending to  the  roof.  Women  are  extremely  sensitive  about  making  any 
seeming  exposure  of  their  limbs  ; — this  fact,  coupled  with  the  confusion 
incident  to  fires,  has,  in  the  opinion  of  experienced  persons,  rendered  the 
ordinary  perpendicular  ladder  next  to  useless.  With  the  flat  treads  the 
ladders  are  converted,  practically,  into  steps  ;  the  inclination  is  easy,  and 
an  uninjured  woman  or  child  may  descend  in  perfect  safety,  and  without 
fear.  This  st}de  of  fire-escape  enables  a  sound  person  to  assist  or  bring 
down  an  injured  or  unconscious  one. 

In  locating  the  ladders,  select  a  side  of  the  building  that  may  be  safely 
covered  by  the  hosemen  standing  on  the  ground.  Do  not  bring  the  lad- 
ders near  the  windows  of  rooms  containing  extra  inflammable  material, 
as  by  so  doing  the  exit  may  be  cut  off"  in  case  of  fire.  For  high  factories, 
where  men  alone  are  employed,  a  good  supplementary  escape  is  one 
of  the  endless  chain  pattern,  the  rate  of  descent  being  graduated  and 
controlled  by  an  escapement  or  friction  governor.  These  escapes  per- 
mit a  continuous  line  of  persons  to  escape,  as  several  may  be  upon  the 
descending  chain  at  a  time.  This  style  of  fire-escape  presupposes  a 
strong  pair  of  uninjured  arms  and  hands,  and  full  possession  of  the  men- 
tal faculties.  Another  pattern  of  escape  is  where  a  belt  encircles  the 
body,  and  has  a  frictional  device  through  which  the  rope  plays,  one  end 
of  which  is  attached  to  the  window  frame.  We  have  seen  a  man  descend 
one  hundred  feet  by  this  means.  This  style  of  escape  can  have  only  a 
partial  approval. 


142  PREVENTABLE  CAUSES  OF  DISEASE,  &=€. 

The  simplest  of  all  escapes  is  a  rope  long  enough  to  reach  the  ground, 
and  attached  to  the  inside  of  each  window  sill, — the  rope,  in  loose  coils, 
hanging  upon  a  hook  or  pin,  ready  to  be  thrown  out  in  case  of  danger. 
This  simple  rope  escape  is  good  for  many  purpospe,  but  cannot  be 
regarded  as  a  safe  escape,  as  an  injured  person  could  not  descend. 

Where  there  is  danger  from  sudden  explosions  or  fire,  and  the  build- 
ing is  not  over  three  stories  high,  the  "  sliding  poles,"  such  as  are  com- 
mon in  the  fire  department  houses,  may  be  used.  They  afford  a  quick 
means  of  reaching  the  ground  with  comparative  safety.  Connected  with 
tlie  factory  office  there  should  be  a  system  of  electric  bells  and  speaking 
tubes.  In  our  factory  they  enter  the  telephone  room  at  the  office.  At 
first  we  had  several  tubes,  but  we  have  found  one  general  tube  to  be 
more  satisfactory.  At  the  office  end,  clustered  around  the  mouth  of  the 
speaking  tube,  are  the  push-buttons  for  the  electric  bells  calling  the  fore- 
men. The  foremen,  in  turn,  have  a  button  calling  the  main  office  ;  also 
one  for  each  of  the  other  foremen.  By  stepping  to  the  tube  and  operat- 
ing the  buttons,  one  can  speak  with  any  or  all  of  the  foremen.  The  ad- 
vantages of  this  system,  in  case  of  fire  or  other  emergency,  are  apparent 
without  further  comment. 

The  escaping  gas  and  odors  from  the  water-closets  are  a  fruitful  cause 
of  disease.  The  water-closets  should  all  have  a  good  "  wash,"  and  be 
trapped  under  the  seat ;  and  another  trap  should  be  added  to  the  pipe  as 
it  nears  the  sewer.  The  closets  of  ordinary  construction  for  the  women 
should  open  from  a  commodious  room,  which  is  to  be  used  as  a  dressing 
room.  The  closet  for  the  men  should  be  provided  with  a  lifting  sub-cover, 
thus  adapting  it  for  either  a  water-closet  or  urinal.  This  suggestion  may  be 
objected  to  by  some,  but  observation  has  convinced  us  that  the  combined 
affair  is  less  offensive  than  the  separate  system.  For  if  the  pans  have  the 
ventilating  tubes  connecting  with  the  ventilating  shafts,  as  is  now  com- 
mon in  all  good  plumbing,  the  constant  wash  of  the  pan  will  prevent  all 
objectionable  odors.  The  seats,  pans,  and  pipes  are  to  rest  upon  iron 
supports.  The  seats  are  to  be  of  hard  wood,  well  filled  ;  no  wood-work 
at  the  front.  The  floor  should  slope  gently  towards  the  front,  and  be 
covered  with  zinc  nailed  off  with  round-headed  zinc  nails,  into  squares 
of  two  or  three  inches  on  a  side.  This  arrangement  permits  the  free  use 
of  the  mop  in  cleaning,  and  suggests  a  clean  place  with  but  little  trouble. 
Many  prefer  the  automatic  operating  valves,  but  we  prefer  the  common 
method  of  handle  and  chain,  as  then  any  required  amount  of  water  may 
be  used.  If  urinals  are  used,  keep  a  piece  of  carbolic  soap  in  each,  and 
flush  them  often.  All  sinks  and  wash-bowls  should  be  trapped.  Have 
all  the  pipes  in  sight,  and  accessible.  Where  chemicals  are  poured 
down  the  sinks,  use  cesspools  covers.  These  are  circular  pieces  of 
wood  covered  on  the  under  side  with  lead  and  rubber,  and  having  an 
earthen  knob  on  top.  Ventilation  should  be  such  that  a  change  of  air  is 
effected  without  drafts  upon  the  head  of  any  person.  This  may  be  ac- 
complished by  placing  the  top  openings,  whether  into  air  shafts  or  to  the 
outside,  well  up,  and  by  keeping  the  inlet  openings  well  down.     Some 


PREVENTABLE  CAUSES  OF  DISEASE,  ^C.  I43 

years  ago  the  writer  served  as  a  junior  member  upon  a  hall  committee 
to  overlook  the  construction  of  a  hall  devoted  to  social  meetings.  We 
had  all  suffered  in  the  old  hall  from  bad  air  and  drafts  of  air,  although 
the  buildmg  v\^as  supposed  to  have  an  elaborate  ventilating  system.  In 
our  new  hall  we  brought  the  hot  air  register  to  the  centre  of  the  hall.  In 
the  wall  of  the  building  was  placed  a  register  connecting  with  an  air 
chute,  which  also  opened  about  the  centre  of  the  hall.  Half  round  win- 
dows, opening  downward,  were  placed  near  the  ceiling.  By  manipulat- 
ing the  openings  according  to  circumstances,  a  comfortable,  well  venti- 
lated hall  was  secured  at  any  season  of  the  year.  A  bald-headed  person 
could  sit  under  any  of  the  open  windows  in  this  hall,  and  not  take  cold. 
We  believe  that  the  drafts  from  the  ordinary  windows  cause  much  sick- 
ness, and  that  the  time  will  come  when  our  advanced  builders  will 
imitate  the  best  car  builders,  and  have  most  of  the  windows  tight,  de- 
pending upon  special  appliances  for  ventilation.  In  all  cases  see  that 
the  new  air  is  pure  air.  Drafts  of  air  cause  much  trouble  in  every  fac- 
tory of  which  we  have  intimate  knowledge.  Many  of  these  cases  may 
be  easily  overcome.  Probably  persons  do  not  differ  as  widely  upon 
other  physical  conditions  as  upon  exposure  to  currents  of  air.  One  man 
may  work  unaffected  in  a  strong  draft,  to  which  his  seemingly  more 
robust  shopmate  would  take  exceptions.  In  those  portions  of  the  coun- 
try where  lung  troubles  and  catarrh  are  common,  great  care  is  required. 
The  sensitive  workman  should  be  permitted,  so  far  as  possible,  to  select 
his  location.  Paper  caps,  having  two  ventilating  holes,  are  useful  in 
many  cases. 

An  important  contributor  to  health  is  the  sunlight.  The  difference 
between  a  well  and  ill  lighted  factory  may  be  practically  illustrated  in 
every  large  city  where  houses,  that  once  were  healthy  homes,  are  now 
sickly  ones, — the  cause  being  directly  traced  to  the  shutting  off  of  the 
sun's  light  by  high  buildings  being  erected  near  them.  For  fine  work, 
where  the  eyes  are  constantly  used,  a  north  light  is  best,  the  workman 
sitting  so  he  receives  the  light  directly  in  front  or  at  the  left  hand.  This 
will  not  shade  the  work  while  using  the  right  hand.  An  opposite  wall 
is  improved  by  giving  it  a  coat  of  whitewash  ;  this  also  gives  a  good 
background  against  which  to  sight  work  while  testing  it.  An  awning 
to  each  window,  although  expensive,  is  the  best  summer  protection  we 
have  seen.  The  portions  of  a  building  most  often  neglected  as  to  light 
are  the  hallways  and  stairways,  and  this  neglect  has  produced  many 
accidents. 

'^  Double  windows"  are  a  protection  in  winter  for  exposed  locations. 
When  used,  one  light  should  be  hinged  for  ventilating  purposes. 

We  think  the  subject  of  lightning-rods  requires  no  further  considera- 
tion than  that  they  be  good  ones,  and  put  up  in  accordance  with  well 
known  laws  of  safety.  Do  not  place  iron  articles  against  them,  as  they 
may  lead  the  lightning  in  a  dangerous  direction.  The  electricity  reaching 
the  ground  during  a  thunder-storm  is  greater  than  many  suppose,  as  the 
rain-water  conductors  carry  down  considerable.     A  friend  of  ours  re- 


144  PREVENTABLE  CAUSES  OF  DISEASE,  &=€. 

ceived  a  severe  shock  while  adjusting  a  disarranged  spout.  If  the  roof 
has  any  considerable  pitch  it  should  be  provided  w^ith  fenders,  to  break 
up  and  hold  the  snow  and  ice,  thus  preventing  the  too  often  disastrous 
slides.  Special  pains  should  also  be  taken  as  to  the  steps.  See  that  the 
drip  from  the  roof  or  porch  does  not  fall  upon  them,  and,  freezing,  make  an 
icy  covering.  The  steps,  if  of  metal  or  stone,  should,  in  a  northern  lati- 
tude, have  a  wooden  covering  in  winter.  Use  sand  upon  the  sidewalks  and 
steps  during  an  icy  time.  The  weight  of  the  snow  itself  is  often  danger- 
ous, even  in  the  case  of  well  constructed  buildings,  but  it  becomes  more 
dangerous,  owing  to  its  increased  weight,  when  saturated  with  water 
after  a  heavy  rain-fall.  In  clearing  the  snow  from  the  roof,  see  that  the 
space  where  it  is  thrown  is  properly  roped  off  and  guarded. 

From  our  own  experience  we  are  fully  impressed  as  to  danger  from 
fire  ;  and  while  we  have  alluded  to  the  subject  in  other  portions  of  this 
article,  there  are  several  matters  that  require  detailed  consideration. 

The  heating  of  the  building  is  best  done  by  means  of  steam-pipes  sur- 
rounding the  rooms.  The  pipes  should  be  supported  by  iron  brackets  ; 
and  in  no  case  are  the  pipes  to  come  near  wood-work,  as  fires  have 
originated  from  this  cause,  the  assertions  of  some  ill-informed  persons  to 
the*  contrary  notwithstanding.  Where  stoves  are  used  they  should  stand 
in  iron  base-pieces,  the  edges  of  which  are  turned  upward  soine  two  or 
three  inches  :  this  prevents  sparks  and  loose  particles  of  coal  from  falling 
on  the  floor.  See  that  the  stove-pipes  are  securely  fastened  by  wires  to 
the  ceiling  and  chimney  ;  that  the  pipe  enters  the  brick-work  flush  with 
the  flue  ;  and  if  the  pipe  is  carried  through  a  partition,  see  that  the  thim- 
ble keeps  the  pipe  well  away  from  the  wood-work.  Keep  the  tops  of 
stove  and  steam-pipe  clear  of  sawdust  and  dirt,  and  pile  nothing  that  will 
drip  or  fall  against  them.  In  burning  sweepings  containing  sawdust,  do  not 
crowd  the  fire  too  much  with  the  door  closed,  as  cases  are  known  where 
the  flames  have,  with  an  explosion,  burst  from  the  door  when  opened  to 
put  in  a  fresh  supply.  One  person  should,  in  each  room,  be  directly  re- 
sponsible for  the  care  of  steam-pipes  or  stoves,  and  the  ventilation.  The 
temperature  that  will  probably  be  the  most  acceptable  to  the  majority  of 
persons  is  from  6^°  to  72°.  The  lights  in  each  room  should  be  under  the 
care  of  one  person  :  this  prevents  a  general  use  of  matches.  Gas-lighting 
should  be  done  with  the  electric  hand-torch,  unless  all  the  burners  are 
connected  with  a  system  of  electric  wires  igniting  all  at  once.  The  gas 
should  be  shut  off'dui-ing  the  day,  and  after  the  building  is  vacated  for  the 
night,  to  prevent  the  leakage,  that  is  always  greater  or  less  where  the 
piping  is  extensive.  In  case  of  a  fire  happening  when  the  gas  is  lighted, 
shut  it  oflfas  soon  as  the  building  is  cleared  :  this  will  shut  off'some  fuel 
from  the  flames.  The  office  supply  may  be  drawn  from  a  separate  me- 
ter, or  that  supply-pipe  may  tap  the  main  pipe  between  the  shut-off' and 
the  meter.  Some  special  provision  should  be  made  for  the  office,  as  that 
department  requires  gas  as  times  when  the  factory  is  not  running.  Se- 
cure gas  and  kerosene  fixtures  from  swinging  against  the  wall  or  under 
shelves.     Steady  all  pendent  fixtures  by  means  of  wires.     Place  protect- 


PREVENTABLE  CAUSES  OF  DISEASE,  &-C.  I45 

ors  over  all  lights  that  come  near  anything  overhead.  The  writer  has 
attended  at  least  one  fire  caused  by  sparks  adhering  to  the  soot  upon  the 
bottom  of  a  glue-pot ;  hence  the  necessity  of  seeing  that  the  fire  is  all  out 
where  the  old-fashioned  glue-pots  are  still  in  use.  We  advocate  the  use 
of  steam  glue-pots,  not  only  for  their  safety,  but  for  their  other  advan- 
tages. Oiled  rags,  saturated  cotton  waste,  and  all  combustible  waste 
material  should  be  collected  at  the  close  of  each  day  and  deposited  under 
the  boilers.  We  know  of  one  large  furniture  manufactory  where  several 
fires  had  occurred  from  the  rags,  saturated  with  filling,  which  was  of  an 
exceedingly  combustible  nature.  The  proprietors,  for  their  own  safety, 
made  a  change  for  a  less  dangerous  composition,  but  at  an  annual  loss 
of  $2,500.  In  our  own  experience  we  have  seen  a  smoking  fire  from 
rags  that  had  been  saturated  with  filling  only  ninety  minutes. 

Ashes  and  all  waste  combustible  material  not  at  once  put  under  the 
boilers  should  be  deposited  in  riveted  or  seamed  metallic  receptacles, 
having  metallic  covers,  and  the  whole  placed  out-doors  at  a  distance  from 
the  buildings.  The  fires  resulting  from  smoking  have  been  so  numerous 
in  the  past,  that  now  most  well  regulated  factories  have  notices  posted, 
prohibiting  smoking  upon  the  premises.  One  of  the  most  noted  manu- 
facturing establishments  in  the  country,  in  order  to  avoid  all  possibility 
of  danger,  prohibits  a  pipe  or  a  cigar  being  brought  into  the  factory. 
The  old-fashioned  sawdust  spittoon  has  yielded  its  full  quota  of  fires,  but 
fortunately  they  have  been  slumbering  ones,  breaking  out  in  the  dead  of 
night,  or  on  Sundays  and  holidays :  so  the  loss  of  life  to  be  attributed  to 
them  is  small.  All  spittoons  should  be  of  earthen  or  of  metal.  If  an  ab- 
sorbent is  required,  use  dry  earth  or  ashes,  as  then,  if  a  match,  cigar- 
stub,  or  other  combustible  article  is  thrown  in,  no  danger  follows. 

A  special  fire-proof  building,  at  a  distance  from  other  buildings,  should 
be  devoted  to  the  oils,  turpentine,  varnish,  and  kindred  combustible 
stock,  only  a  day's  supply  being  removed  at  a  time.  When  the  boiler- 
room  is  left,  even  though  temporarily,  see  that  the  openings  under  the 
boiler  are  closed.  We  had  a  fire  in  our  factory,  the  result  of  a  fifteen 
minutes  absence  of  the  fireman,  who  left  his  under  door  open,  also  the 
one  into  the  fuel-room.  A  brisk  spring  breeze  blew  out  a  line  of  shav- 
ings that  formed  a  pathway  for  the  fire  to  a  bin  of  very  combustible  ma- 
terial, and  it  was  only  after  a  stubborn  fight  that  the  building  was  saved. 
In  establishments  requiring  the  use  of  lenses,  see  that  these  articles  are  not 
left  where  they  will  focus.  The  writer  once  had  a  stereoscopic  view  de- 
stroyed, the  instrument  holding  it  being  left  in  a  window.  Matches 
should  be  kept  in  iron  self-closing  holders,  the  stock  to  be  kept  in  cov- 
ered tin  or  earthen  vessels.  Keep  the  yards  and  surroundings  free  from 
straw,  old  cases,  and  all  rubbish.  One  of  the  worst  fires  we  ever  saw 
was  a  second  fire  catching  in  some  straw  by  a  spark  from  the  original 
fire,  a  distance  away.  Keep  the  yard  well  wet  down  in  dry  times.  If 
there  is  a  shaving-chute,  see  that  it  is  tight,  and  does  not  drop  any  dust  or 
shavings  till  the  shaving-bin  is  reached.  This  chute  is  to  have  a  shut-oft', 
which  is  to  be  promptly  closed  upon  a  fire  alarm  being  given. 


146  PREVENTABLE  CAUSES  OF  DISEASE,  &-C. 

A  volume  might  easily  be  written  upon  the  dangers  from  naphtha  and 
benzine.  Although  the  temptation  is  strong  to  use  them,  they  should  be 
banished  from  the  factory.  Where  printing-presses  are  used,  substitute 
turpentine  for  cleaning  off  the  rolls.  Some  of  the  carburetors  in  the 
market  are  very  dangerous,  from  the  fact  that  they  use  the  dangerous 
products  of  petroleum,  vs^hich,  leaking  through  the  service-pipes,  cause 
explosions  if  a  fire  or  light  is  present.  Keep  telegraph  and  telephone 
poles  avv^ay  from  the  buildings,  as  the  w^ires  cause  the  loss  of  precious 
minutes  to  the  firemen  in  raising  the  ladders. 

The  system  of  sprinklers  introduced  within  the  past  few  years  affords 
great  protection.  Perhaps  the  best  evidence  we  can  produce  in  their 
support  is  the  favorable  opinion  of  the  underwriters.  Briefl}'^,  this  system 
consists  of  pipes  extending  over  the  ceilings  to  the  rooms,  hall-ways,  and 
stair-ways.  These  pipes  are  provided  with  a  sprinkler  about  every  eight 
feet.  Each  of  these  sprinklers  is  stopped  by  a  cap  held  in  position  by 
fusible  solder,  melting  for  ordinary  cases  at  150°  for  engine-rooms,  or  dry- 
houses  at  200°.  The  water  pressure  being  constant,  a  wetting  down  is 
assured  in  case  of  fire.  In  our  factory  we  have  had  two  occasions  to  test 
them.  Each  time  they  went  off  by  the  heated  air  or  smoke,  the  live 
flame  not  reaching  to  them.  Their  work  was  regarded  as  most  satisfac- 
tory. One  pattern  of  the  hand-grenade  is  in  our  house  and  in  the  fac- 
tory. While  these  articles,  perhaps,  add  another  means  of  security,  too 
much  dependence  should  not  be  placed  upon  them. 

The  public  tests  of  all  this  class  of  extinguishers  seem  satisfactory,  but, 
from  age  or  other  causes,  they  seem  to  lose  their  power.  Five  of  our 
quart  size  were  thrown  at  a  neighboring  fire  without  checking  it.  We 
then  ran  out  our  private  line  of  hose  and  stopped  it.  The  automatic  elec- 
tric fire  alarm  sounds  a  bell  when  the  heat  reaches  a  certain  point :  this 
makes  it  an  efficient  monitor  in  case  of  fire.  It  is  of  especial  value  for 
store-rooms  and  parts  of  the  building  not  constantly  occupied. 

Electric  light  lines  should  be  well  guarded,  as  fires  have  resulted  from 
their  disarrangement.  The  wires,  unless  properly  protected,  are  danger- 
ous to  the  touch  when  the  electric  current  is  on.  Accidents  have  resulted 
from  the  wires'  being  touched.  When  the  fire  is  the  result  of  a  defective 
electric  light  apparatus,  use  great  caution  in  applying  the  water,  other- 
wise the  person  throwing  it  may  be  knocked  over.  Throw  the  water 
from  the  pail  so  it  will  leave  in  a  mass.  If  it  forms  a  continuous  stream, 
a  current  is  established.  We  can  mention  one  fire  from  this  cause,  where 
two  men,  in  trying  to  put  it  out,  were  repeatedly  knocked  over,  until  the 
cause  suggested  itself,  when  they  threw  the  water  in  masses  without  fur- 
ther trouble  till  the  current  at  the  central  supply  was  shut  off. 

The  following  constitute  the  fire  apparatus  outside  the  building :  A 
hydrant  with  hose  attached  :  the  hose  is  coiled  up  and  safely  "  housed" 
from  the  weather  in  a  closet  erected  against  the  wall.  The  wrench  for 
turning  on  the  water  is  also  hung  up  in  the  closet.  The  door  is  simply 
buttoned  :  then  any  one  may  use  the  apparatus  in  an  emergency.  Against 
the  wall,  under  a  protection  from  the  weather,  hang  a  strong  ladder,  with 


PREVENTABLE  CAUSES  OF  DISEASE,  &=€.  147" 

spikes  at  the  bottom  end,  a  scaling-ladder  having  hooks  at  its  upper  end, 
and  a  fire-hook.  This  hook  of  iron,  with  a  chain  attached,  is  mounted 
upon  a  long,  stout  pole.  A  rope  is  attached  to  the  chain.  The  inside 
portable  fire  apparatus,  distributed  at  accessible  points,  consists  of  tubs 
and  pails  of  water,  fire-axes,  ropes  with  hooks  attached  for  drawing  up 
hose,  and  hand  fire-grenades  (if  they  can  be  made  to  hold  their  vitality). 
Have  at  the  foot  of  each  flight  of  stairs  a  fire-axe,  a  lantern  filled  with 
sperm  or  lard  oil,  and  one  or  more  pails  of  water.  The  water  in  the  tubs 
and  pails,  if  in  a  freezing  temperature,  is  to  be  saturated  with  salt.  Each 
workman  should  have  his  appointed  place  for  fire  duty.  All  the  hose 
and  hydrant  couplings  should  have  couplings  corresponding  with  those 
of  the  local  fire  department. 

Dust  may  be  classed  under  two  heads, — first,  that  ordinarily  recog- 
nized as  dust,  being  a  miscellaneous  collection  of  fine  particles,  contain- 
ing more  or  less  decaying  matter  ;  and,  secondly,  the  finely  disintegrated 
portions  of  material  thrown  off  in  the  mechanical  process  of  manufactur- 
ing. The  first  is  easily  managed,  so  an  ordinary  regard  for  neatness  ren- 
ders a  detailed  consideration  unnecessary.  The  steam-pipes  are  apt  too 
often  to  be  neglected,  the  very  fine  dust  accumulating  being  thrown  off 
and  mixed  with  the  atmosphere  when  the  steam  is  suddenly  let  on.  The 
rooms  should  be  swept  after  the  day's  work  is  done,  using  moist  sawdust 
for  a  sprinkling.  This  keeps  the  dust  down,  and  the  floor  will  soon  dry. 
Mechanical  dust  is  more  difficult  to  manage.  The  ordinary  wood  saw- 
dust is  now,  in  the  best  regulated  factories,  conveyed  by  suction,  pro- 
duced by  a  fan-wheel,  to  a  bin,  or  room  adjacent  to  the  boiler-room, 
w^here  it  is  burned  under  the  boilers,  with  other  refuse.  These  ducts, 
while  serving  an  admirable  purpose,  are  also  dangerous  in  case  of  fire, 
furnishing  a  direct  communication  to  the  most  inflammable  portions  of 
the  factory,  the  shut-offs  being  the  only  safety.  Dust  from  sanding  and 
polishing  machines,  which  are  revolving  disks,  drums,  or  reciprocating 
surfaces  covered  with  sand-paper,  may  be  also  withdrawn  by  the  air 
l)last  into  a  bin  or  receptacle  by  itself.  Black  walnut  sawdust  is  partic- 
ularly offensive  to  persons  of  catarrhal  tendencies,  and  needs  to  be  care- 
fully looked  after.  In  case  of  metals,  the  dust  may  be  removed  from 
in  front  of  the  workman  by  suction  or  a  blast  of  air.  Persons  who  have 
l>een  troubled  from  metal  dust  have  been  enabled  to  continue  their  work 
by  growing  a  moustache,  which  caught  the  particles  before  they  could 
reach  the  nostrils.  In  large  cities  and  towns,  where  the  water-supply  is 
•drawn  from  a  common  source,  the  water  usually  is  good,  but  in  isolated 
factories  where  resource  is  had  to  wells,  great  caution  is  needed  to  avoid 
pollution  from  drains,  manufacturing  waste,"  etc.  The  ice  supply  is 
Iiardly  at  all  recognized  as  a  source  of  danger,  yet  it  is  important  that  the 
ice  used  come  from  a  clear  body  of  water,  and,  if  not  in  motion,  large 
enough  to  furnish  clear  blocks  of  ice  free  from  dirt.  Do  not  use  ice  cut 
from  small  ponds,  or  the  inlets  of  large  ones,  as  these  places  are  usually 
the  dumping-places  of  dead  animals,  and  other  objectionable  refuse. 
The  most  satisfactory  method  of  cooling  water  we  have  seen,  is  where 


148  PREVENTABLE  CAUSES  OF  DISEASE,  &'C. 

the  water  flows  through  block-tin  pipes  encircling  the  ice  chamber.  This 
gives  water  cold  enough  for  ordinary  purposes.  Where  the  work  is 
exhaustive,  or  the  weather  excessively  hot,  we  recommend  that  broken 
ice  be  placed  in  a  non-conducting  receptacle.  A  piece  of  ice  the  size  of 
a  walnut  held  in  the  mouth  will  be  refreshing.  Before  using  water  or 
ice,  rinse  the  mouth  thoroughly.  Evidently  many  of  the  so-called  pros- 
trations by  heat  should  be  attributed  to  the  immoderate  use  of  ice-water. 
In  most  manufacturing  establishments  there  is  a  considerable  amount  of 
"handling"  the  goods  in  the  process  of  manufacturing,  transporting  it 
from  one  part  of  the  factory  to  another.  This  work  is  generally  done  by 
cheap  and  unskilled  hands,  and  many  accidents  result  from  the  lack  of 
skill  and  the  proper  appliances  for  doing  the  work.  Where  the  rooms 
are  on  the  same  level,  and  the  pieces  are  large  and  heavy,  a  track  should 
be  laid,  the  rails  of  which  are  even  with  the  floor.  Upon  this  track  the 
platform  car  is  pushed.  A  differential  pulley  block  and  chain  raises  and 
lowers  the  articles  holding  them  at  any  point.  For  general  factory  use 
we  have  found  the  platform  trucks  to  give  satisfaction.  These  trucks  are 
made  of  a  length  to  be  taken  upon  the  freight  elevator.  They  can 
then  be  taken  up-stairs,  down-stairs,  run  over  the  connecting  bridge 
between  buildings,  through  doorways,  and,  in  fact,  in  any  portion  of  the 
establishment  where  it  is  desired  to  carry  goods.  This  truck  is  a  wooden 
platform  mounted  on  an  iron  axle  and  wheels,  with  a  trail-wheel  at  each 
end.  It  has  stakes  which  are  removable.  The  tops  of  the  wheels  are 
below  the  surface  of  the  platform.  Some  accidents  result  from  hand- 
ling cased  goods,  because  the  workmen  cannot  get  hold  of  them.  It  is 
difficult  to  hold  a  heavy  case  with  the  hook  found  in  the  hardware  stores, 
but  with  a  specially  constructed  hook  our  shipper  claims  he  can  hold  as 
much  as  two  men  with  the  common  hooks.  Ours  has  a  good  point. 
The  back  curve  is  like  the  ordinary  hook.  The  forward  curve  does  not 
extend  too  far  out,  but  enough  to  give  a  good  leverage  on  the  case  or  box. 
The  handle  or  ^ank  portion  slightly  recedes,  and  is  flattened  out  so  as 
to  fit  nicely  between  the  fingers.  The  length  is  about  double  that  of 
ordinary  hooks.  It  is  hard  work  for  even  a  clumsy  man  to  receive  a 
"  pinch  "  while  using  this  hook. 

Do  not  start  the  engine  during  the  noon  hour,  or  at  other  times  when 
not  expected,  without  giving  due  notice,  as  otherwise  there  is  danger  of 
somebody's  being  injured  if  he  is  cleaning  or  overhauling  the  machin- 
ery. There  should  be  a  complete  code  of  signals  for  the  engine-room, 
.leading  from  every  portion  of  the  factory  where  machinery  is  used.  The 
gong  used  should  be  of  a  size  to  be  easily  heard  in  the  boiler-room,  as 
then  the  stoker  can  shut  oft'  the  engine  if  the  engineer  is  temporarily  ab- 
sent. Many  distressing  accidents  happen  by  persons  being  caught  in  the 
shafting  and  machinery.  The  prompt  stopj^ing  of  the  engine  is  of  the 
utmost  importance.  In  too  many  shops  the  engineer  is  also  the  steam 
and  gas  engineer  of  the  establishment,  and  is  more  frequently  found  in 
the  shop  than  in  the  engine-room. 

Avoid  oiling  accidents  by  doing  this  work  out  of  work  hours  (when 


PREVENTABLE  CAUSES  OF  DISEASE,  Q^C.  I49 

the  shafting  is  at  rest),  paying  the  workman  detailed  a  special  price  for 
the  constant  supervision.  The  jars  and  motion  communicated  to  the 
workmen  by  machineiy  and  pounding  are  more  injurious  than  at  first 
supposed.  The  body  absorbs  the  concussion,  and  produces  a  tired  feel- 
ing upon  all  but  the  most  robust. 

The  difference  between  a  well  and  poorly  conducted  factory  is  as  great 
as  between  riding  in  a  Pullman  and  a  caboose.  Great  care  is  needed 
relating  to  noise.  Workmen  on  up-stairs  floors  should  be  cautioned 
against  jumping  from  the  benches  to  the  floor,  or  dropping  tools  or  heavy 
pieces  of  work.  Sheets  of  thick  rubber  are  used  with  good  results  under 
pounding-blocks,  etc.,  to  absorb  the  jar.  Even  in  well  constructed  build- 
ings the  addition  of  a  special  beam  or  brace  will  often  prevent  the  trouble 
from  jarring  machinery.  In  our  factory  the  annoyance  from  a  fussy  jig- 
saw, running  at  a  high  rate  of  speed,  was  overcome  by  this  method. 
Heavy  machinery  upon  the  first  floor  would  best  rest  upon  a  separate 
foundation. 

For  general  purposes  the  best  seats  will  be  found  to  be  the  ordinary 
four-legged,  wooden-seated  stool,  with  a  home-made  back  added.  This 
back  is  a  thin  piece  of  springy  board,  the  top  rounded  ofl'and  bolted  to 
the  seat  and  lower  round.  This  seat  is  easily  mounted  and  dismounted. 
For  persons  standing  or  sitting,  a  foot-rest  will  be  found  of  great  service, 
for,  by  frequently  changing  from  one  foot  to  the  other,  the  limbs  are  kept 
in  a  good  condition.  This  is  important  to  rheumatic  and  heavy-limbed 
persons.  Experience  has  taught  us,  that,  other  things  being  equal,  in 
making  a  journey  we  should  select  a  route  having  cars  with  side  foot- 
rests. 

Saws  are  the  leading  element  of  danger  in  many  factories.  Probably 
ninety  per  cent,  of  all  the  accidents  are  the  direct  result  of  the  violation 
of  that  golden  rule,  "  Never  put  your  hand  back  of  a  running  saw."  A 
piece  of  wood  sticks  a  little,  or  a  chip  lodges  at  the  back  of  the  saw :  the 
temptation  presents  itself  for  the  workman  to  remove  it  without  stopping 
the  saw.  He  takes  the  risk,  and  perhaps  carries  a  mutilated  hand 
through  life  as  the  result.  At  the  back  of  medium  and  large  splitting 
saws,  use  a  "  horn."  This  keeps  the  cut  open,  and  permits  the  saw  to 
do  its  duty  without  pinching.  Saws,  in  many  kinds  of  work,  may  be 
covered,  presenting  only  a  slight  cutting  surface.  Many  of  the  circular 
saws  are  made  for  special  work,  and  differ  from  the  old-fashioned  type 
in  that  a  certain  proportion  of  the  teeth  are  hooked,  instead  of  pointing 
outward.  A  workman  would  be  badly  mutilated  on  the  former  saw  by 
his  hand's  being  drawn  in,  w^hile  the  latter  would  have  a  negative  if  not  a 
repelling  motion.  It  will  be  seen  why  these  new  saws  demand  great 
care  upon  the  part  of  those  running  them.  The  foreman  of  our  wood- 
shop  says  "  he  does  not  want  a  man  to  touch  a  saw  who  is  afraid  of  it." 
He  instructs  a  new  hand  as  to  the  dangers,  how  to  avoid  them,  and  ex- 
pects a  cautious  confidence  to  do  the  rest.  During  his  administration  of 
several  years  there   has  not  been   a   serious   injury  in   his   department. 

Universal  moulding-machines,  and  others  of  that  class,  using  a  post  or 


150  PREVENTABLE  CAUSES  OF  DISEASE,  &'€. 

cutter-head  for  holding  the  cutters,  are  most  dangerous  articles.  The 
tendency  is  to  draw  in  anything  brought  in  contact.  The  general  re- 
marks applied  to  saws  apply  to  these.  There  is  one  danger  from  these 
machines,  even  to  the  experienced  hand, — that  is,  he  may  forget,  when 
shifting  the  knives,  to  tighten  them  up  if  his  attention  is  temporarily 
called  away.  We  had  one  accident  of  this  nature  in  our  factory.  It  has 
been  said  there  is  not  a  person  who  has  run  one  of  these  machines  any 
length  of  time  who  has  escaped  without  mutilation  or  cuts.  We  cannot 
contradict  the  assertion  from  our  own  knowledge. 

In  showing  visitors  over  a  manufacturing  establishment,  request  them 
to  lay  aside  their  cigars,  and  impress  upon  them  the  importance  of  con- 
sidering each  piece  of  machinery  as  in  motion.  A  nicely  running  saw 
or  cutter-head,  to  many,  conveys  the  idea  of  an  object  at  rest. 

Grindstones,  if  running  at  a  high  speed,  should  be  covered.  They,  as 
well  as  emery  wheels,  should  be  placed  in  a  room  by  themselves,  or  in  a 
corner,  out  of  the  way  of  the  other  workmen.  Many  bad  accidents  have 
been  the  result  of  broken  wheels.  Fewer  belt  accidents  would  occur 
were  loose  pulleys  more  generally  used,  instead  of  leaving  a  belt  to  hang- 
on  the  shaft  when  not  in  use,  and  putting  on  while  running. 

Some  workmen  have  a  practice  of  laying  down  their  tools  with  the 
cutting  end  projecting  over  the  edge  of  the  bench.  This  is  done  to  save 
the  cutting  surface.  A  better  plan  is  to  lay  the  tool  point  away  from  the 
workman,  and  resting  on  pieces  of  wood  on  the  bench.  We  recall  a 
case  of  a  marketman,  who,  leaving  his  knife  pointing  outward,  jumped 
forward  in  the  act  of  hanging  up  some  mutton,  and  received  a  fatal 
wound. 

The  liquor  question,  in  a  general  way,  it  may  not  be  proper  for  us  to 
consider,  but  in  its  bearings  upon  factory  life  it  is  important.  No  work- 
man should  be  permitted  to  work  while  under  the  influence  of  liquor, 
nor  to  run  a  piece  of  machinery  till  he  has  fully  recovered  from  the 
effects  of  a  spree.  The  chronic  disordered  condition  of  some  workmen, 
after  vacations  and  holidays,  has  caused  many  liberal-minded  employers 
to  contract  the  days  off  to  the  smallest  possible  number. 

Accidents  arise  from  amateur  railroading,  as  in  many  cases  the  work- 
men act  as  switchmen  or  brakemen  where  side  tracks  enter  the  factory 
grounds.  If  possible,  the  side  track  should  be  in  a  straight  line,  as  then 
a  fair  view  may  be  had.  Cars  should  not  be  moved  at  all  without  timely 
instruction  and  notice.  It  is  quite  common,  where  there  are  several  cars, 
to  leave  one  or  more  spaces  for  a  passage-way  through.  Fatal  accidents 
have  resulted  from  pushing  the  cars  together  without  notice.  Reckless 
engineers  delight  in  giving  the  cars  a  good  "kick"  in  switching,  when 
they  know  a  green  hand  is  at  the  brake.  This  trick  was  played  upon  a 
friend  of  ours  upon  his  own  j^remises.  Had  one  of  his  men  been  at  the 
brake,  a  fatal  accident  would  have  been  the  result.  Even  with  his  expe- 
rience and  strength,  the  car  reached  the  dead  end  with  a  force  that  threw 
him  from  the  car,  leaving  him  hanging  from  the  brake  by  his  powerful 
arms. 


PRE  VENTABLE  CA  USES  OF  DISEASE,  &^C.  1 5  I 

Machinery  kept  constantly  running,  and  under  inspection,  is  less  liable 
to  break  down  and  cause  accidents  than  where  it  remains  idle  a  good 
portion  of  the  time. 

Where  the  workmen  are  of  good  habits,  it  is  better  in  depressed  times 
to  give  vacations  in  turn  rather  than  close  entirely,  or  to  give  full  work 
to  only  a  few. 

We  believe  in  placing  a  seriously  injured  person  as  soon  as  possible 
under  the  care  of  a  competent  surgeon.  In  most  places  a  few  minutes 
must  elapse  befoi'e  such  skill  is  obtainable  :  hence  the  importance  of  such 
intelligent  action  as  will  present  the  patient  to  the  doctor  in  the  best  con- 
dition. Concise  elementary  directions  in  case  of  accidents,  published 
under  medical  supervision,  are  now  obtainable  in  the  large  cities.  These 
are  printed  upon  card-board,  and  at  least  one  of  these  notices  should  be 
posted  in  every  factory.  To  supplement  and  carry  out  the  medical  direc- 
tions recommended,  an  emergency  box  should  be  kept  safely  in  some 
known  place,  and  under  the  charge  of  some  cool-headed,  intelligent  per- 
son. The  emergency  box  should  contain  a  few  bottles  of  medicine,  such 
as  brandy,  arnica,  etc.,  prepared  by  an  apothecary,  each  bottle  properly 
labelled.  The  selection  of  the  medicine  should  be  left  to  a  doctor  or  to 
an  apothecary,  who  has  knowledge  of  the  dangers  of  the  factory.  Besides 
the  above,  each  case  should  contain  a  Martin's  rubber  bandage,  and  a 
piece  of  rubber  tube  for  tying  ;  some  small,  strong  rubber  bands.  These 
articles  are  for  use  in  case  of  bleeding.  A  box  of  surgeon's  plaster,  cloth 
bandages,  sponge,  graduated  glass  (tea  and  table-spoonfuls) ,  a  medicine 
holder  with  spout,  and  a  folding  fan. 

From  a  lay  point  of  view  we  think  the  medical  gentlemen  have,  In  their 
instructions,  given  all  that  is  required  where  assistance  is  within  easy 
call,  excepting  the  manner  of  handling.  This  subject  has  not  received 
the  attention  it  should,  as  "kind  hands"  are  often  very  ignorant  and 
clumsy.  We  believe  a  series  of  illustrations,  showing  the  proper  man- 
ner of  lifting  and  supporting  sick  or  wounded  persons,  would  be  of  great 
benefit,  not  only  to  the  factory,  but  also  for  the  home. 

A  factory  located  in  a  good-sized  city  has  the  advantages  of  hospital 
ambulance  and  police  patrol  service.  Where  such  wagons  are  in  use,  we 
recommend  that  each  factory  should  own  a  stretcher  fitting  the  vehicles. 
By  this  means  a  disabled  person  may  at  once  be  laid  upon  a  stretcher 
ready  for  the  hospital  attendants  upon  their  arrival.  For  other  purposes, 
use  a  stretcher  constructed  in  accordance  with  the  views  of  the  local 
doctor,  not,  however,  losing  sight  of  the  removable  handles,  by  which 
means  in  severe  cases  the  handles  may  be  removed,  leaving  the  canvas 
upon  the  bed  and  under  the  patient. 

To  obtain  the  des^  medical  attendance  is  often  a  serious  matter  for  the 
disabled  mechanic,  owing  to  his  lack  of  funds.  The  public  hospitals  in 
the  large  cities  are  all  that  could  be  expected,  but  they  cannot  cover  the 
whole,  and  take  care  of  every  one  needing  medical  assistance.  Every 
establishment  employing  one  hundred  hands  or  over  should  organize  a 
mutual  relief  association,  for  the  purpose  of  paying  medical  fees  and 


152  PREVENTABLE  CAUSES  OF  DISEASE,  6-C. 

nursing.  The  money  could  be  used  for  paying  for  a  free  bed  in  some 
hospital.  Where  this  convenience  does  not  exist,  an  upper  room  in 
some  comfortable  building  should  be  secured  for  the  dangerously  sick  or 
wounded.  We  think  in  an  establishment  of  ordinary  risk  a  regular  con- 
tribution of  ten  cents  a  week  will  be  sufficient  to  pay  all  ordinary  de- 
mands ;  any  excess  to  be  assessed,  but  not  to  exceed  twenty  five  cents  in 
any  one  week.  Many  workmen  regard  going  to  a  hospital  as  but  one 
remove  from  entering  a  jail.  This  ignorant  idea  should  be  dispelled,  and 
would  be  by  an  acquaintance  with  any  good  hospital  where  trained  nurses 
are  employed.  This  idea,  we  feel,  is  quite  common  ;  and  more  popular 
information  is  required,  so  that  a  man  will  believe  he  enters  a  hospital  to 
be  cured^  and  not  to  die. 

A  shop  danger  (but  thanks  to  local  health  officers  a  lessening  one)  is 
that  from  contagious  diseases.  Most  American-born  workmen  recognize 
and  respect  the  benefit  of  restriction  in  such  cases.  Many  of  foreign  birth 
disregard  these  limitations,  and  recklessly  endanger  their  fellow-workmen. 
As  the  latter  are  almost  invariably  the  ignorant  and  most  superstitious,  re- 
lying upon  charms  rather  than  upon  medical  skill  to  effect  a  cure,  the 
remedy  suggested  would  seem  to  be, — restraining  power  first,  then  popular 
instruction.  We  consider  the  subject  of  personal  cleanliness  of  more  im- 
portance than  the  general  shop  condition.  We  know  of  a  painter  who 
attributes  a  large  portion  of  the  sickness  of  his  trade  to  their  handling  their 
food  and  face  with  soiled  hands, — his  rule  being  to  keep  his  hands  away 
from  his  mouth  unless  they  are  perfectly  clean.  The  hair  and  whiskers  re- 
quire to  be  kept  clean.  Few  persons  are  aware  how  readily  they  absorb 
and  hold  impurities  and  particles  from  the  atmosphere.  In  cleaning  up, 
a  few  drops  of  ammonia  in  warm  water  will  be  found  an  excellent  wash 
for  the  hair  and  whiskers,  as  it  is,  indeed,  for  the  rest  of  the  body.  Hot 
water  cannot  always  be  conveniently  carried  over  a  building.  In  our 
factory  we  overcame  the  difficulty  in  this  way :  Our  washing-up  sinks 
are  the  ordinary  long  iron  ones.  At  one  end  is  placed  a  copper  vessel 
holding  several  gallons.  A  cold-water  pipe  leads  to  this  vessel,  and  a 
steam  pipe  enters  it.  By  turning  the  steam  valve  the  water  may  be 
blown  up  and  heated  as  hot  as  desired.  The  hot  water  from  this  tank  is 
dipped  into  the  basin,  and  tempered  from  the  independent  cold  water 
faucet  to  suit. 

Workmen  who  bring  their  dinners  should  be  furnished  with  facilities 
for  heating  or  making  tea  or  coffee.  The  refuse  of  all  fruits,  peach- 
stones  and  banana  skins  in  particular,  should  be  thrown  into  some 
proper  receptacle.  The  floor  is  a  most  dangerous  place  when  sprinkled 
with  these  articles. 

Persons  at  work  over  j^oisonous  substances  should  talk  but  little  while 
at  work  :  by  so  doing  they  breathe  more  through  the  nose.  We  have  in 
mind  a  great  talker, — a  painter, — whose  system  seemed  to  be  charged 
with  tl:e  white  lead  paint  which  he  applied  to  small  articles  upon  the 
bench  before  him.  His  room-mates,  of  a  less  gossiping  nature,  escaped 
seemingly  uninjured.     The  above  occurred  in  a  better  lighted  and  venti- 


PREVENTABLE  CAUSES  OF  DISEASE,  cr'C.  1 53 

lated  paint  room  than  is  ordinarily  seen.  The  physician  summoned  to 
this  painter  quickly  diagnosed  the  trouble  as  lead  poisoning,  and  stated 
the  cause  as  readily  as  though  he  had  been  a  shop-mate. 

Most  factories  abreast  of  the  times,  whether  engaged  in  metal, 
wood,  or  textile  manufacturing,  have  special  processes  m  which  the  use 
of  poisonous  chemicals  is  required.  These  should  be  kept  in  glass  or 
earthen  receptacles,  properly  labelled  with  the  word  "  Poison,"  the  anti- 
dote also  being  added.  The  best  chemists  now  furnish  their  prepara- 
tions thus  labelled. 

Economy  of  space  in  some  buildings  requires  that  the  overhead  (ceil- 
ing) spaces  be  used.  Where  this  is  done,  keep  the  articles  hung  up  away 
from  over  the  work-benches  as  much  as  possible.  Use  hooks  or  pins, 
the  outer  ends  of  which  are  the  highest.  This  prevents  jars  sending  down 
the  articles  hung  up.  Pack  goods  on  overhanging  shelves  so  they  can- 
not be  shaken  down.  Keep  tools,  flower-pots,  etc.,  off" the  window-sills, 
unless  there  is  a  guard  to  the  window.  One  of  our  most  respected  state 
governors,  now  in  office,  once  had  a  narrow  escape  from  a  flower-pot 
that  fell  from  an  upper  window. 

Observation  has  convinced  us  that  the  ordinary  set  rules,  no  matter 
how  well  framed,  are  distasteful  to  the  average  person,  and  fall  short  of 
the  mark.  Our  attention  was  recently  called  to  a  set  of  rules  for  the 
guidance  of  a  large  bindery  and  printing  establishment.  It  would  hardly 
be  possible  for  any  one  to  comply  with  all  of  the  requirements.  One 
rule,  however,  so  covered  the  whole  that  we  repeat  it  from  memory : 
"An  honest  day's  work  will  be  required  for  a  full  day's  pay."  Any  per- 
son who  is  not  willing  to  comply  with  this  should  be  discharged.  Each 
foreman  should  be  held  accountable  for  those  in  his  immediate  depart- 
ment, and  he  should  have  authority  to  discharge  for  cause.  He  should 
be  consulted  in  taking  on  new  hands. 

The  introduction  of  special  machinery  in  almost  every  manufacturing 
department,  has,  in  our  opinion,  a  tendency  to  dwarf  the  man  mentally, 
less  skilled  hand- work  being  required  than  under  the  old  system.  What 
we  now  consider  as  a  trade  was  once  only  a  part  of  a  trade.  This  dwarf- 
ing of  the  mental  faculties  requires  a  counteracting  influence,  which  must, 
we  believe,  come  mainly  through  reading.  We  advocate  anything  that 
will  enlarge  and  improve  the  inental  condition.  In  view  of  the  above, 
we  recommend  that  each  establishment  have  only  the  common  rules 
posted,  such  as  relate  to  smoking,  elevators,  etc.,  and  that  all  details  be 
printed  in  book  form  and  given  to  each  person  employed.  This  book  is 
to  convey,  in  the  way  of  suggestions^  what  is  expected.  The  ideal  must 
not  be  above  the  reach  of  any  person  in  the  factory.  The  truth  should 
be  advanced,  that  the  interests  of  employer  and  employes  are  identical. 
Each  person  should  feel  that  he  is  responsible  for  not  only  his  own  wel- 
fare, but  also  for  that  of  his  shop-mates.  We  believe  such  a  presentation 
of  the  case  will  arouse  in  each  workman  an  idea  of  his  responsibilities, 
and  a  purpose  to  incorporate  the  suggestions  in  his  daily  shop-life. 


APPENDIX. 


1 


PUBLICATIONS 


Agerican  puHic  Health  i|^^oGialioq. 


The  following  constitute  the  published  works  of  the 
Association  : 

Volume  I — 563  pages — contains  48  papers  by  44  authors. 
Volume  II — 553  pages — 43  papers  by  39  authors. 
Volume  III — 241  pages — 39  papers  by  29  authors. 
Volume  IV — 396  pages — 37  papers  by  33  authors. 
Volume  V — 256  pages — 20  papers  by  19  authors. 
Volume  VI — 497  pages — 36  papers  by  36  authors. 
Volume  VII — 446  pages — 33  papers  by  30  authors. 
Volume  VIII — 359  pages — 21  papers  by  20  authors. 
Volume  IX — 453  pages — 26  papers  by  26  authors. 
Volume  X — 536  pages — 46  papers  by  43  authors. 

A  total  of  339  different  papers  by  222  authors,  not  including  i3  presi- 
dential addresses,  and  many  verbatim  reports  of  interesting  discussions 
of  important  questions. 

Volume  XI   (now  in  press). 
Lomb  Prize  Essays,  1885. 

The  above  constitutes  in  itself  a  library  upon  sanitation,  as  will  be  seen 
in  the  more  detailed  analysis  of  the  same  in  the  following  pages.  So 
great  has  been  the  demand  for  these  works  in  this  and  foreign  countries, 
that  but  a  few  complete  sets  remain  for  sale  in  the  hands  of  the  treas- 
urer. 


LIST  OF  AUTHORS, 

WITH    THE    TITLES    OF    THEIR    RESPECTIVE    PAPERS,    IN   THE 

FIRST    TEN    VOLUMES     OF    THE    PUBLICATIONS    OF    THE 

AMERICAN   PUBLIC    HEALTH   ASSOCIATION. 


VOL.  I.— AUTHORS,  ALPHABETICALLY  ARRANGED. 

1.  Allen,  Nathan,  M.  D.,  LL.  D. 

1.  Perfection  of  Structure  in  the  Human  Body  as  a  Leading  Element  of  Hygiene. 

2.  Bailey,  F.  K.,  M.  D. 

2.  Cholera  in  Knoxville,  Tenn.,  and  Vicinity. 

3.  Barnard,  F.  A.  P.,  LL.  D.,  President  Columbia  College. 

3.  The  Germ  Theory  of  Disease  in  its  Relations  to  Hygiene. 

4.  Beard,  George  M.,  M.  D. 

4.  The  Longevity  of  Brain-Workers. 

5.  Beekman,  Hon.  James  W. 

5.  Remarks  upon  one  of  the  First  Principles  of  Hospital  Hygiene. 

6.  Blodgett,  Lorin,  Esq. 

6.  Report  upon  "  Non-Periodic  Changes  of  Heat  as  an  Element  in  Sanitary  Cli 

matology." 

7.  Board  of  Health,  of  Little  Rock,  Ark. 

7.  Cholera  in  Little  Rock,  Ark. 

8.  Chandler,  C.  F.,  Ph.D.,  M.D.,  LL.D. 

8.  Report  upon  the  Sanitary  Chemistry  of  Waters,  and  Suggestions  with  regard 

to  the  Selection  of  the  Water-Supply  of  Towns  and  Cities. 

9.  Clendenin,  William,  M.  D. 

9.  The  General  Causes  of  Disease. 

10.  Cox,  Christopher  C,  M.  D.,  LL.  D. 

10.  A  Report  upon  the  Necessity  for  a  National  Sanitary  Bureau. 

11.  Erskine,  John  H.,  M.  D. 

11.  A  Report  on  Yellow  Fever  as  it  appeared  in  Memphis,  Tenn.,  in  1873. 

12.  Flint,  Austin,  M.  D. 

12.  Relations  of  Water  to  the  Propagation  of  Fever. 

13.  GiLMORE,  J.  T.,  M.  D. 

13.  An  Account  of  Yellow  Fever  as  it  prevailed  in  Mobile  and  Vicinity  in  1873. 

14.  Harris,  Elisha,  M.  D. 

14.  Practical  Conclusions  concerning  Cholera.     Evidence  respecting  Causes  and 

Preventive  Measures. 

15.  General  Health  Laws  and  Local  Ordinances  considered  with  reference  to 

State  and  Local  Sanitary  Organization. 

15.  Hartshorn,  Henry,  M.  D. 

16.  What  to  do  against  Yellow  Fever. 

16.  Hunt,  Ezra  M.,  M.  D. 

17.  The  Need  of  Sanitary  Organization  in  Villages  and  Rural  Districts. 

17.  Janes,  Edward  H.,  M.  D. 

18.  Report  on  the  Practical  Lessons  of  the  Recent  Prevalence  of  Small-Pox, 
with  reference  to  its  Prevention  in  the  Future. 

18.  JEPSON,  S.  L.,  M.  D. 

19.  Cholera  in  Wheeling,  West  Va.,  in  1873. 


LIST  OF  AUTHORS.  1 59 

19.  JUDSON,  Adoniram  B.,  M.  D. 

20.  History  and  Course  of  the  Epizootic  among  Horses  upon  the  North  Ameri- 
can Continent  in  iSy2-y;^. 

21.  Report  upon  the  Course  of  Cholera  through  Two  Hundred  Towns  and 
Cities  in  the  Mississippi  Valley. 

20.  Leas,  C.  A.,  M.  D. 

22.  A  Report  upon  the  Sanitary  Care  and  Utilization  of  the  Refuse  of  Cities. 

21.  Lebby,  Robert,  M.  D. 

23.  Principles  and  Practice  of  Quarantine  at  the  Port  of  Charleston,  South 

Carolina. 

22.  Marsden,  William,  M.  D. 

24.  Plan  of  a  Hospital  and  Cleansing  Establishment  for  the  Treatment  of 
Cholera,  and  Guarding  against  its  Introduction  at  Ports  and  Places  of 
Entrance. 

23.  Miller,  B.  C,  M.  D. 

25.  Cholera  as  it  Prevailed  in  Chicago  in  1873. 

24.  McClellan,  Ely,  M.  D.,  Assistant  Surgeon,  U.  S.  A. 

26.  An  Account  of  the  Epidemic  of  Cholera  during  the  Summer  of  1873  in 
Eighteen  Counties  in  the  State  of  Kentucky. 

25.  Perry,  A.  W.,  M.  D. 

27.  Effectual  External  Regulations  without  Delay  to  Commerce. 

26.  Peters,  John  C,  M.  D. 

28.  The  Origin  and  Spread  of  Asiatic  or  Bengal  Cholera. 

27.  Pettenkofer,  Max  Von,  M.  D.,  of  Munich. 

29.  What  we  can  do  against  Cholera. 

28.  Pfeiffer,  Carl,  F.  A.  I.  A. 

30.  A  Report  upon  Sanitary  Relations  to  Health  Principles  of  Architecture. 

29.  QuiNN,  J.  J.,  M.  D. 

31.  Cholera  in  Cincinnati,  Ohio. 

30.  Russell,  Charles  P.,  M.  D. 

32.  A  Report  on  a  Uniform  System  of  Registration  of  Causes  of  Death  through- 

out the  United  States. 

31.  Russell,  S.  C,  M.  D. 

33.  Some  Account  of  Yellow  Fever  as  it  appeared  in  New  Orleans  in  1873. 

32.  Sevier,  W.  R.,  M.  D. 

34.  Report  upon  Epidemic  Cholera  as  it  appeared  at  Jonesborough,  Tenn. 

33.  Smith,  Heber,  M.  D.,  Surgeon  in  charge  U.  S.  M.  H.  Service,  port  of  New  York. 

35.  Sailors  as  Propagators  of  Disease. 

34.  Smith,  Stephen,  M.  D. 

26.  On  the  Limitations  and  Modifying  Conditions  of  Human  Longevity,  the 
Basis  of  Sanitary  Work. 

37.  Local  Measures  of  Prevention  and  Relief  to  be  adopted  during  the  Preva- 
lence of  Epidemic  Cholera. 

35.  Snively,  W.,  M.  D. 

38.  Report  on  Asiatic  Cholera. 

36.  Stockton-Hough,  John,  M.  D. 

39.  On  the  Relative  Influence  of  City  and  Country  Life  on  Morality,  Health, 

Fecundity,  Longevity,  and  Mortality. 

37.  Toner,  Joseph  M.,  M.  D. 

40.  The  Distribution  and  Natural  History  of  Yellow  Fever  as  it  has  occurred  at 
different  times  in  the  United  States. 

41.  Boards  of  Health  in  the  United  States. 

38.  Van  Deman,  J.  H.,  M.D. 

42.  Cholera  in  Chattanooga,  Tenn.,  and  Cities  South  of  Nashville,  during  the 

Summer  of  1873. 

39.  Van  Der  Poel,  S.  O.,  M.  D. 

43.  General  Principles  affectmg  the  Organization  and  Practice  of  Quarantine. 


l6o  LIST  OF  AUTHORS. 

40.  Walker,  Prof.  Francis  A.,  Superintendent  U.  S.  Census. 

44.  The  Relations  of  Race  and  Nationality  to  Mortality  in  the  United  States. 

41.  Waller,  Elwyn,  A.  M.,  E.  M.  of  the  School  of  Mines,  New  York. 

45.  Report  on  Disinfection  and  Disinfectants. 

42.  White,  Hon.  Andrew  D.,  President  Cornell  University. 

46.  Sanitary  Science  in  its  Relations  to  Public  Instruction. 

43.  White,  C.  B.,  M.  D. 

47.  Report  of  Cholera  in  New  Orleans. 

44.  WooDWORTH,  John  M.,  M.  D.,  Supervising  Surgeon  U.  S.  M.  H.  Service. 

48.  Some  Defects  in  the  Immigration  Service,  including  one  Report  of  the  Board 
of  Health. 


VOL.  II.— AUTHORS,  ALPHABETICALLY  ARRANGED. 

1.  Baker,  Henry  B.,  M.  D. 

1.  Report  on  the  Death  Rate  of  each  Sex  in  Michigan,  and  a  Comparison  with 

Dr.  Farr's  Life  Tables  of  Healthy  Districts  in  England. 

2.  Bell,  A.  N.,  M.  D. 

2.  Perils  of  the  School-Room. 

3.  Billings,  John  S.,  M.  D. 

3.  Abstract  of  Special  Reports  by  Army  Medical  Officers  on  the  Effect  of  Moun- 

tain Climates  upon  Health. 

4.  Notes  on  Hospital  Construction.. 

4.  Black,  J.  R.,  M.  D. 

5.  Influence  of  Hereditary  Defects  on  Health,  their  Prevention  and  Eradication. 

5.  Brown,  Harvey  E.,  M.  D. 

6.  Yellow  Fever  on  the  Dry  Tortugas. 

6.  Busey,  S.  C,  M.  D. 

7.  The  Gathering,  Packing,  and  Free  Marketing  of  Fresh  Vegetables  and  Fruits. 

7.  Committee,  Report  of. 

8.  Report  of  Committee  on  a  Sanitary  Survey  of  the  United  States. 

8.  Cook,  Prof.  George  H. 

9.  The  Drowned  Lands  of  Orange  County,  N.  Y.,  and  Sussex  County,  N.  J. — 

Their  Drainage. 

9.  Dean,  Henry  W.,  M.  D. 

10.  Sanitary  Principles  in  Home  Architecture. 

10.  Donaldson,  Prof.  F. 

11.  Influence   of   City  Life   and  Occupations  in  Developing  Pulmonary  Con- 

sumption. 

11.  DUNOTT,  T.  J.,  M.  D. 

12.  Advantages  of  Small  Hospitals  or  Infirmaries  for  Manufacturing  and  Mining 

Towns. 

12.  Eaton,  Dorman  B.,  LL.  D. 

13.  Essential  Conditions  of  Good  Sanitary  Administration. 

13.  Fryer,  B.  E.,  M.  D. 

14.  Influence  of  the  High  Altitudes  and  Climate  of  the  Table-Land  Country  of 
the  Rocky  Mountain  Region  upon  Health  and  Disease. 

14.  Gross,  Samuel  D.,  M.  D.,  LL.  D.,  D.  C.  L.  Oxon. 

15.  The  Factors  of  Disease  and  Death  after  Injuries.— Parturition  and  Surgical 

Operations. 

15.  Hambleton,  F.  H.,  C.  E. 

16.  A  Plea  for  Sanitary  Engineering. 

16.  Harris,  Eltsha,  M.D. 

17.  Report  on  the  Public  Health  Service  in  the  Principal  Cities  and  Sanitary 

Works  in  the  United  States. 

17.  Harrison,  W.  G.,  Jr.,  M.  D. 

18.  Alcoholic  Drinks  in  Relation  to  Life  Insurance. 


LIST  OF  AUTHORS.  '  l6l 

i8.  Hartshorne,  Henry,  M.  D. 

19.  Report  on  Sanitary  Conditions  of  Watering-Places. 

20.  Infant  Mortality  in  Cities. 

19.  Hitchcock,  Homer  O.,  M.  D. 

21.  Relations  of  Excessive  Use  of  Alcoholic  Drinks  to  Public  Health. 

20.  Hunt,  Ezra  M.,  M.  D. 

22.  Building-Ground  and  Dwelling-Houses  in  their  Relations  to  Health. 
31.  Hunt,  Sanford  B.,  M.  D. 

23.  Soil  Drainage  and  Atmospheric  Humidity. 

22.  Janes,  Edward  H.,  M.  D. 

24.  Health  of  Tenement  Populations — Sanitary  Requirements  of  their  Dwellings. 

23.  Kedzie,  R.  C,  M.  D. 

25.  Report  on  Poisons  as  Insecticides  in  Agriculture,  and  Tests  of  their  Effects 
on  Food  Vegetables. 

24.  Kerr,  Prof.  W.  C. 

26.  Geological  and  Sanitary  Relations  of  Drainage  and  Water  Supply  in  No 
Carolina. 

25.  Law,  Prof.  James,  D.  V.  S. 

27.  Hereditary  Entailments  in  Domestic  Animals  and  in  the  Human  Family. 

28.  Report  on  Malignant  Anthrax  in  Herds  and  Malignant  Pustule  in  Man  (on 
the  Wadsworth  estate). 

26.  Lee,  Benjamin,  M.  D. 

29.  Cost  of  a  Great  Epidemic  to  a  Great  City. 

27.  Maisch,  Prof.  John  M. 

30.  Pharmacy  in  its  Sanitary  Relations. 

28.  Noel,  H.  R.  M.  D. 

31.  Sewer-Gas  as  a  Cause  of  Diphtheria  and  Typho-Malarial  Diseases. 

29.  Orton,  Prof.  Edward,  A.  M. 

32.  Certain  Relations  of  Geology  to  the  Water-Supplies  of  the  Country. 

30.  Osgood,  Samuel,  D.  D.,  LL.  D. 

33.  Health  and  the  Higher  Culture, 

31.  Pepper,  William,  M.  D. 

34.  The  Sanitary  Relations  of  Hospitals. 

32.  Smith,  Stephen,  M.  D. 

35.  The  Reciprocal  Relations  of  an  Efficient  Public  Health  Service  and  the 

Highest  Educational  Qualifications  of  the  Medical  Profession. 

36.  Hospitalism  and  Hospital  Construction. 

33.  Snow,  Edwin  M.,  M.  D.  -. 

37.  Does  Small-Pox  become  Epidemic,  or  Spread  only  by  its  own  Contagion  ? 

34.  Steiner,  Hon.  L.  H.,  M.  D. 

38.  A  Sanitary  View  of  the  Question,  "  Am  I  my  Brother's  Keeper  ?" 

35.  Sternberg,  George  M.,  M.  D. 

39.  Yellow  Fever  in  Pensacola,  Fla.,  in  i873-'4-'5. 
26.  Sturgis,  F.  R.,  M.  D. 

40.  Relations  of  Syphilis  to  the  Public  Health. 

37.  Toner,  Joseph  M.,  M.  D. 

41.  The  Leading  Public  Health  Questions  in  the  United  States. 

38.  VIELB,  E.  L,  C.E. 

42.  Principles  and  Practice  of  Drainage  and  Sewerage,  in  connection  with  Water- 

Supplies. 

39.  Woodworth,  John  M.,  M.  D. 

43.  Location,  Plan,  and  Management  of  Hospitals,  including  one  Report  of  Com- 
mittee. 


1 62  LIST  OF  AUTHORS. 

VOL.  III.— AUTHORS,  ALPHABETICALLY  ARRANGED. 

1.  Bell,  A.  N.,  M.  D. 

1.  Marine  Hygiene  on  board  Passenger  Vessels. 

2.  Billings,  John  S.,  M.  D. 

2.  Rights,  Duties,  and  Privileges  of  the  Community  in  relation  to  those   of  th, 

Individual  in  regard  to  Health. 

3.  Brevi'er,  Prof.  William  H. 

3.  The  Gases  of  Decay,  and  the  Harm  they  cause  in  Dwellings,  &c. 

4.  Claypole,  Prof.  E.  W. 

4.  The  Popularization  of  Sanitary  Science  in  Schools. 

5.  Committee,  Report  of. 

5.  Report  on  the  Preparation  of  a  Plan  for  a  Sanitary  Survey  of  the  United 

States. 

6.  Crov\^ell,  Henry  G. 

6.  Sanitary  Regulations  relating  to  Abattoirs. 

7.  Flint,  Austin,  M.  D. 

7.  Food  in  its  relations  to  Personal  and  Public  Health. 

8.  Gardner,  James  T.,  C.  E. 

8.  Relations  of  Topographical  Surveys  and  Maps  to  Public  Health. 

9.  Garvin,  Lucius  F.  C,  M.  D. 

9.  Sanitary  Requirements  in  Factories — Injurious   Effects  of  Cotton  Factories 

upon  the  Health  of  Operatives. 
ID.  Gihon,  a.  L.,  M.  D. 

ID.  The  Need  of  Sanitary  Reform  in  Ship  Life. 

11.  Harris,  Elisha,  M.  D. 

II.  Laws,  Provisions,  and  Methods  for  securing  the  Benefits  of  General  Vacci- 
nation throughout  the  Country. 

12.  Horsford,  Prof.  E.  N. 

3  2.  A  New  Profession  in  the  service  of  Hygiene. 

13.  Hough,  Franklin  B.,  M.  D. 

13.  Health  Interests  in  the  Preservation  of  certain  Primeval  Forests,  and  the 
Cultivation  of  Trees. 

14.  Hunt,  Ezra  M.,  M.  D. 

14.  The  Sanitary  Appointments  and  Outfitting  of  Dwelling-Houses. 

15.  Janes,  Edward  PI.,  M.  D. 

1 5.  Abattoirs  and  the  Slaughtering  Business  in  New  York. 

16.  Lente,  Frederick  D.,  Jr.,  M.  D. 

16.  Florida  as  a  Ileal th  Resort. 

17.  Lewis,  Charlton  T.,  Esq. 

17.  Ancient  and  Modern  Hygiene  Contrasted — Influence  of  Civilization  on  the 
Duration  of  Life. 

18.  Morris,  John,  M.  D. 

18.  Scarlatina  in  Baltimore  and  Belair,  Md. 

19.  Pfeiffer,  Carl,  F.  A.  I.  A. 

19.  A  Report  on  Methods  of  Ventilation. 

20.  Segur,  B.  a.,  M.  D. 

20.  Privy  Vaults  and  Cesspools. 

21.  SiiEDD,  J.  Herbert,  C.  E. 

21.  Water-Supplies  for  Large  Institutions  and  Small  Communities. 

22.  Smith,  Stephen,  M.  D. 

22.  The   Influence  of  Private  Dwellings  and  other  Habitations  on  Public  Hy- 
giene :  the  Relations  of  Sanitary  Authority  to  them. 

23.  Steiner,  Lewis  H.,  M.  D. 

23.  Expert  Supervision  in  Construction  of  Public  Institutions. 

24.  Walker,  Jerome,  M.  D. 

24.  Summer  Resorts  for  the  Dcljilitated  Children  of  our  Cities. 


LIST  OF  AUTHORS.  1 63 

25.  Waring,  George  E.,  Jr. 

25.  The  Sanitary  Condition  of  Country  Houses  and  Grounds. 

26.  Washburn,  Emory,  LL.  D. 

26.  Expert  Testimony  and  the  Public  Service  of  Experts. 

27.  White,  C.  B.,  M.  D. 

27.  Disinfection  in  Yellow  Fever,  as  Practised  in  New  Orleans — Evidence  of  its 

Efficacy. 

28.  Wood,  Edward  S.,  M.  D. 

28.  Illuminating  Gas  in  its  Relations  to  Health. 

29.  WooDwoRTH,  John  M.,  M.  D. 

29.  The  Safety  of  Ships  and  of  those  who  Travel  in  them,  including  one  Report 

of  Committee. 


VOL.  IV.— AUTHORS,  ALPHABETICALLY  ARRANGED. 

1.  Ames,  Azel,  M.  D. 

1.  The  Removal  and  Utilization  of  Domestic  Excreta. 

2.  Andrew,  George  L.,  M.  D. 

2.  The  Sanitary  Value  of  Forests. 

3.  Austin,  W.  G.,  M.  D. 

3.  The  Epidemic  of  1839. 

4.  Brewer,  Prof.  William  H. 

4.  Practical  Suggestions  concerning  Tree-Planting  for  Sanitary  Effects. 

5.  Chesbrough,  E.  S.,  C.  E. 

5.  The  Drainage  and  Sewerage  of  Chicago. 

6.  Choppin,  Samuel,  M.D. 

6.  History  of  the  Importation  of  Yellow  Fever  into  the  United  States  from  1693 

to  1878. 

7.  Delegation  from  Mississippi  State  Board  of  Health. 

7.  Report  of  the  Delegation  from  the  Mississippi  State  Board  of  Health  to  the 

American  Public  Health  Association. 

8.  Dexter,  Wirt,  Esq. 

8.  Public  Economy  of  Sanitary  Measures  :  an  Address  of  Welcome. 

9.  DUNOTT,  T.  J.,  M.  D. 

9.  Sanitary  Safety  in  Railway  Travelling — Suggestions  in  the  Interest  of  Travel- 

lers and  Carriers. 

10.  Gregory,  J.  M.,  LL.  D. 

ID.  Hygiene  and  Higher  Education. 

11.  Hand,  D.  W.,  M.D. 

11.  Epidemic  of  1864. 

12.  HAfeRis,  Elisha,  M.  D.  (chairman). 

12.  Report  on  a  Sanitary  Survey  of  the  United  States  (continued). 

13.  Report  on  Plans  for  Complete  and  Authentic  Records  of  Deaths  and  Causes 
of  Death  in  the  United  States. 

14.  Significance  of  the  Recent  Epidemic — Duties  of  the  American  Public  Health 
Association. 

13.  Hartshorne,  Henry,  M.D. 

15.  On  the  Geographical  Element  in  the  Etiology  of  Yellow  Fever,  and  its  Bear- 
ing upon  Prevention. 

14.  Hereford,  Rev.  Dr. 

16.  Public  Holidays  and  Public  Health. 

15.  Herrick,  S.  S.,  M.D. 

17.  Propositions  relative  to  the  Etiology  of  Yellow  Fever. 

16.  Hewitt,  Charles  N.,  M.  D. 

18.  The  Work  of  Hygiene  in  the  Education  of  Children  in  the  Common  Schools, 

and  in  the  Families  and  Society  in  which  they  Live. 


1 64  LIST  OF  AUTHORS. 

17.  Hitchcock,  Prof.  Edward. 

19.  Hygiene  at  Amherst  College. 

18.  HOLLID.-VY,  D.  C,  M.D. 

20.  Is  Efificient  Quarantine  Possible  or  Practicable  ? 

19.  Hunt,  Ezra  M.,  M.  D. 

21.  How  to  Study  an  Epidemic. 

22.  The  Prophylactic  Treatment  of  Individuals  as  a  Means  of  Preventing  Epi- 
demics of  Yellow  Fever,  or  other  Infective  Diseases. 

20.  Jennings,  R.  G.,  M.  D. 

23.  The  Quarantine  at  Little  Rock,  Ark.,  during  August,  September,  and  Octo- 
ber, 1878,  against  the  Yellow  Fever  Epidemic  in  Memphis  and  the  Missis- 
sippi Valley. 

21.  Le  Conte,  John  L.,  M.  D. 

24.  Sanitary  Problems :  the   Proper  and  Rational  Method  in  which  Municipal 

Boards  of  Health  should  be  Organized. 

22.  LiNDSLEY,  J.  B.,  M.  D. 

25.  Report  on  the  Yellow  Fever  in  Nashville,  Tenn..  September  and  October, 

1S78. 

23.  Lyman,  Henry  M.,  M.D. 

26.  A  Review  of  the  Present  State  of  Exact  Knowledge  regarding  the  Causation 
of  Epidemic  Infectious  Diseases. 

24.  Morris,  John,  M.  D. 

27.  History  of  the  Epidemic  in  Baltimore  in  1876. 

25.  McClellan,  Ely,  M.  D. 

28.  A  Study  of  the  Yellow  Fever  Epidemic  of  1876,  as  it  affected  the  State  of 

Georgia. 

26.  Plunket,  J.  D.,  M.  D. 

29.  Disinfection  of  Sewers  by  Ozone.  ' 

27.  Rauch,  John  H.,  M.  D. 

30.  The  Sanitary  Problems  of  Chicago. 

28.  Selden,  William,  M.  D. 

31.  Views  on  the  Subject  of  Prevention  of  Yellow  Fever. 

29.  Smart,  Charles,  M.  D. 

32.  Abstract  of  a  Report  on  the  Spring,  Well,  and  River  Waters  in  the  Depart- 

ment of  the  Platte,  made  to  the  Medical  Director  U.  S.  Army,  under  date  of 
May  26,  1876. 

33.  Abstract  of  a  Report  on  Certain  Points  in  Medical  Climatology. 

30.  Steiner,  Lewis  H.,  M.  D. 

34.  An  Address  on  the  Objects  of  the  Association,  and  its  Claims  upon  the  Peo- 
ple for  Sympathy  and  Support. 

31.  Taylor,  J.  Howard,  M.  D. 

35.  Memorandum  concerning  the  Refugee  Cases  of  Yellow  Fever  in   Philadel- 

phia, 1878. 

32.  Turner,  T.  J.,  A.  M.,  M.  D.,  Ph.  D. 

36.  Air  and  Moisture  on  Shipboard  :  a  Fragment  of  Applied  Physiology. 

33.  Vandeman,  J.  H.,  M.  D. 

37.  Yellow  Fever  as  it  Existed  in  Chattanooga,  Tenn. — Its  Origin,  Progress, 
and  the  Probable  Remedy  for  its  Abatement  in  the  Future,  including  one 
Report  of  Delegation. 


VOL.  v.— AUTHORS,  ALPHABETICALLY  ARRANGED. 

1.  Brewer,  Prof.  W.  H. 

1.  On  Rotting  Wood. 

2.  Cameron,  Col.  John  F. 

2.  Camps — Depopulation  of  Memphis — Epidemics,  1878  and  1879. 


LIST  OF  A  UTHORS.  1 65 

3.  Campbell,  Henry  F.,  M.  D. 

3.  The  Yellow  Fever  Quarantine  of  the  Future,  as  Organized  upon  the  Porta- 

bility of  Atmospheric  Germs,  and  upon  the  Non-Contagiousness  of  the  Dis- 
ease. 

4.  Chandler,  J.,  M.  D. 

4.  How  to  Deal  with  a  First  Case  and  Early  Cases  of  Yellow  Fever,  when,  in 

spite  of  Precautions,  it  has  made  its  Appearance. 

5.  Clarke,  Eliot  C,  C.  E. 

5.  City  Scavengering  in  Boston. 

6.  CoMPTON,  J.  W.,  M.  D. 

6.  Underground  Sewers. 

7.  CuMMiNGS,  John  B.,  M.  D. 

7.  The  Inefficiency  of  Quarantine  in  the  State  of  Arkansas  during  the  Year  1879. 

8.  GiHON,  Albert  L.,  M.  D. 

8.  On  the  Protection  of  the  Innocent  and  Helpless  Members  of  the  Community 

from  Venereal  Diseases  and  their  Consequences. 

9.  James,  Bushrod  W.,  M.  D. 

9.  International  Quarantine. 

10.  Janeway,  Edw^ard  G.,  M.  D. 

10.  Remarks  upon  Necessity  for  the  Filing  in  a  Public  Office  of  Plans  and 

Statements  about  Certain  Matters  of  House  Construction — Upon  the  Study 
of  the  Origin  of  Contagious  Diseases,  and  the  Liability  to  Error  in  this  Di- 
rection— Upon  the  Necessity  for  Uniformity  in  the  Publication  of  Vital  Sta- 
■  tistics. 

11.  On  Post-Mortem  Examinations  and  their  Relations  to  the  Public  Health. 

11.  Jennings,  R.  G.,  M.  D. 

12.  Quarantine  and  its  Results  in  the  State  of  Arkansas,  1879. 

12.  MuNROE,  Prof.  Charles  E.,  U.  S.  N.  A. 

13.  Action  of  Vegetable  Acids  on  Tin. 

13.  Plunket,  J.  D.,  M.  D. 

14.  Cotton  as  a  Fomite. 

14.  Smith,  Stephen,  M.  D. 

15.  History  of  the  Association. 

15.  Thompson,  Rev.  Hugh  Miller. 

16.  Method  Introduced  by  the  Auxiliary  Sanitary  Association  for  Disposing  of 
the  Garbage  of  New  Orleans. 

16.  Thornton,  G.  B.,  M.  D. 

17.  Yellow  Fever  Epidemic  in  Memphis,  1879. 

17.  Tyner,  T.  J.,  M.D. 

18.  Etiology  of  Yellow  Fever,  with  Remarks  on  Quarantine. 

18.  Waring,  George  E.,  Jr.,  C.  E. 

19.  The  Sewerage  and  Drainage  of  Cities. 

19.  Woodhull,  Alfred  A.,  M.  D. 

20.  May  not  Yellow  Fever  Originate  in  the  United  States  ? 


VOL.  VI.— AUTHORS,  ALPHABETICALLY  ARRANGED. 

1.  Atchison,  T.  A.,  M.  D. 

1.  The  Disposal  of  our  Dead. 

2.  Baker,  Henry  B.,  M.  D. 

2.  The  Relations  of  Schools  to  Diphtheria,  etc. 

3.  Bell,  A.  N.,  M.  D.,  A.  M. 

3.  The  Relations  of  Certain  Filth  Diseases  to  Cold  Weather. 

4.  Brewer,  Prof.  William  H. 

4.  On  the  Action  of  Muddy  Water  on  Sewage. 


1 66  LIST  OF  AUTHORS. 

5.  Brooks,  Hon.  Erastus. 

5.  What  the  State  owes  the  People. 

6.  Chaille,  Stanford  E.,  A.  M.,  M.  D. 

6.  A  Consideration  of  the  Objections  Urged  by  Some  Evolutionists  against  Saiv- 

itary  Laws,  etc. 

7.  Crane,  James,  M.  D. 

7.  The  Prevention  of  Certain  Contagious  Diseases  by  Local  Boards  of  Health- 

8.  Devron,  Gustavus,  M.  D. 

8.  Abattoirs. 

9.  DeWolf,  O.  C,  M.  D. 

9.  The  Results  of  Attempting  to  Check  the  Spread  of  Small-Pox  in  Chicago. 

10.  DuNGAN,  D.  PL,  M.  D. 

10.  Some  Suggestions  in  regard  to  Sanitation  and  the  Drainage  of  Small  Cities 
and  Towns. 

11.  Eaton,  Hon.  John. 

11.  Sanitation  and  Education. 

12.  Gallatin,  James,  Esq. 

12.  The  Tenement-House  Reform  in  the  City  of  New  York. 

13.  Gamgee,  Prof.  John. 

13.  The  Sanitary  Urgency  of  the  Florida  Ship-Canal. 

14.  GiBBS,  B.  F.,  M.  D. 

14.  A  New  Method  of  Investigation  into  the  Causes  of  Yellow  Fever,  upon  the 

Basis  of  Similar  Densities. 

15.  Hargis,  R.  B.  S.,  M.  D. 

15.  Yellow  Fever  Recognition  and  Isolation. 

16.  Harris,  Elisha,  M.  D. 

16.  The  Domestic  Pestilences  Viewed  with  Reference  to  the  Sanitary  Warfare 
against  them. 

17.  Herrick,  S.  S.,  M.  D. 

17.  Numerical  Sanitation :  a  Calculus  of  Subsoil  Dramage  in  New  Orleans. 

18.  HOLLIDAY,  D.  C,  M.  D. 

18.  Dengue,  or  Dandy  Fever. 

19.  HoRLBECK,  Henry  B.,  M.  D. 

19.  A  Brief  Synopsis  of  "Breakbone"  or  Dengue  Fever,  as  Prevailing  in 
Charleston,  S.  C,  in  the  Summer  of  18S0. 

20.  Hunt,  Ezra  M.,  M.  D. 

20.  Our  Present  and  our  Needed  Knowledge  of  Epidemics. 

21.  James,  Bushrod  W.,  M.  D. 

21.  Abattoirs  Improve  the  Sanitary  Condition  of  Cities. 

22.  Keating,  J.  M.,  Esq. 

22.  The  Value  of  Sanitation  from  an  Economic  Standpoint. 

23.  Lester,  F.  W.,  M.  D. 

23.  Report  on  Yellow  Fever  in  Key  West,  Fla.,  in  1S80. 

24.  Moore,  Robert,  C.  E. 

24.  Storm-Water  and  House-Drainage  in  Sewers. 

25.  Pinkham,  J.  G.,  M.D. 

25.  The  Sanitary  Association  of  Lynn,  Mass. 

26.  Pope,  J.  H.,  M.  D. 

26.  The  Condition  of  the  Mexican  Population  of  Western  Texas  in  Relation  to 

Public  Health. 

27.  Porcher,  F.  Peyre,  M.  D. 

27.  Nature,  Cause,  Extension,  and  Relations  of  Dengue  or  "  Breakbone  "  Fever 
in  South  Carolina,  Summer  of  1880;  also  Contrasted  with  Yellow  and  Ma- 
larial Fevers. 

28.  Scales,  T.  S.,  M.  D. 

28.  Municipal  Sanitation  as  Practised  in  Mobile  for  Preventing  the  Spread  of 
Yellow  Fever. 


LIST  OF  A  UTHORS.  167 

29.  Smith,  Joseph  R.,  M.  D. 

29.  Disease  among  Texas  Cattle. 

30.  Sternberg,  George  M.,  M.  D. 

30.  Yellow  Fever  and  Quarantine. 

31.  Storer,  Horatio  R.,  M.D. 

31.  Sanitary  Protection  in  Newport. 

32.  Thomas,  J.  G.,  M.D. 

32.  Dengue. 

33.  Thornton,  G.  B.,  M.D. 

33.  Memphis  Sanitation  and  Quarantine,  1879  ^.nd  1880. 

34.  Turner,  T.  J.,  M.  D. 

34.  The  Hygiene  of  Emigrant  Ships. 

35.  Waring,  George  E.,  Jr.,  C.  E. 

35.  Storm-Water  in  Town  Sewerage. 

36.  Wight,  O.  W.,  M.  D. 

36.  The  Management  of  Contagious  and  Infectious  Diseases  in  Milwaukee. 


VOL.  VII.— AUTHORS,  ALPHABETICALLY  ARRANGED. 

1.  Adams,  J.  F.  A.,  M.  D. 

1.  Malaria  in  New  England. 

2.  Brooks,  Hon.  Erastus. 

2.  What  the  People  owe  to  the  State. 

3.  Burgess,  Daniel  M.,  M.D. 

3.  Practical  Experiences  in  regard  to  the  Infection  of  Vessels  with  Yellow  Fe- 

ver at  Havana. 

4.  Cabell,  J.  L.,  M.  D. 

4.  The  Rise  and  Progress  of  International  Hygiene. 

5.  Campbell,  Prof.  John  L. 

5.  "  The  Kankakee : "  a  Sanitary  Problem  of  Indiana. 

6.  Chamberlain,  C.  W.,  M.  D. 

6.  Malaria  in  Connecticut. 

7.  Curtis,  W.  H.,  M.  D. 

7.  The  Disposal  of  the  Dead. 

8.  Duncan,  T.  C,  M.D. 

8.  The  Atmospheric  Element  in  Epidemics. 

9.  Fenner,  Edward,  Esq. 

9.  History  of  the  New  Orleans  Auxiliary  Association, 

10.  FoLsoM,  Charles  F.,  M.  D. 

ID.  The  Prevention  of  Insanity. 

11.  Foster,  Eugene,  M.  D. 

11.  The  Municipal  Organization  of  the  American  Public  Health  Service. 

12.  Garnett,  Alex.  Y.  P.,  M.  D. 

12.  Observations  on  the  Potomac  Marshes  at  Washington,  D.  C. 

13.  GiHON,  Albert  L.,  M.  D. 

13.  Health  the  True  Nobility. 

14.  GORGAS,  A.  C,  M.  D. 

14.  Effects  of  Tobacco  on  Youths. 

15.  Herrick,  S.  S.,  M.D. 

15.  Railroad  Sanitation,  its  Objects  and  Advantages. 

16.  The  Comparative  Vital  Movement  of  the  White  and  Colored  Races  in  the 
United  States. 

16.  Horlbeck,  H.  B.,  M.D. 

17.  Scarlet  Fever  in  Charleston,  S.  C. 

17.  Hunt,  Ezra  M.,  M.  D. 

18.  The  Contagious  Diseases  of  Domestic  Animals. 


1 68  LIST  OF  AUTHORS. 

i8.  Jeffries,  B.  Joy,  M.  D. 

19.  The  Control  of  Defective  Vision  on  Land  and  Sea. 

19.  Jones,  H.  Isaac,  M.  D. 

20.  School  Hygiene. 

20.  Miles,  Abijah  J.,  M.D. 

21.  The  Sunstroke  Epidemic  of  Cincinnati,  O.,  during  the  Summer  of  1881. 

21.  Nagle,  John  T.,  M.  D. 

22.  Suicides  in  New  York  city. 

22.  Partridge,  J.  M.,  M.  D. 

23.  Trichinae  Spiralis :  its  History,  Pathology,  and  Diagnosis.  / 

23.  Runnels,  Moses  T.,  M.  D.  [ 

24.  Impure  Water  and  its  Dangers.  •  I 

24.  Smith,  Joseph  R.,  M.  D. 

25.  Disease  among  Texas  Cattle.  I 

26.  Report  of  Examinations  for  Trichinae  of  Hogs  killed  at  San  Antonio,  Texas. 

25.  Smith,  Stephen,  M.  D. 

27.  Maritime  Sanitary  Service. 

26.  Speed,  John  J.,  M.  D. 

28.  Inside  Sources  of  Disease. 

27.  Turner,  T.  J.,  M.  D. 

29.  National  and  International  Sanitary  Jurisprudence. 

28.  Van  Bibber,  W.  C,  M.  D. 

30.  Two  Suggestions  concerning  Healthy  Buildings. 

29.  White,  C.  B.,  M.  D. 

31.  A  Report  of  the  Examination  of  Hogs  at  the  New  Orleans  Abattoir,  with 
reference  to  Trichinae  Spiralis. 

32.  The  Yellow  Fever  Epidemic  at  New  Orleans  in  1878. 

30.  Wright,  A.  R.,  M.  D. 

33.  Memorandum  of  Probable  Cause  of  an  Epidemic  of  Diarrhceal  Diseases  in 
Buffalo,  N.  Y.,  in  1881. 


VOL.  VIIL— AUTHORS,  ALPHABETICALLY  ARRANGED. 

1.  Abbott,  Samuel  W.,  M.  D. 

1.  Uses  and  Abuses  of  Animal  Vaccination. 

2.  Bell,  A.  N.,  M.  D. 

2.  Sanitary  Inspection. 

3.  Brooks,  Hon.  Erastus. 

3.  Sanitary  Government — Principles  and  Facts. 

4.  Work  of  the  State  Board  of  Health  of  New  York. 

4.  Cabell,  J.  L.,  M.  D. 

5.  A  Review  of  the  Operations  of  the  National  Board  of  Health. 

5.  Cantwell,  a.  W.,  M.  D. 

6.  A  Summer  Epidemic  of  Small-Pox  caused  by  Direct  Importation  from  Ger- 

many. 

6.  Coggshall,  Bela,  M.  D. 

7.  Is  Tubercular  Consumption  a  Contagious  and  Parasitic  Disease? 

7.  Compton,  J.  W.,  M.  D. 

8.  Large  Combined  Sewers  dangerous  to  Public  Health. 

8.  Detwiller,  John  W.,  M.  D. 

9.  Small-Pox  in  Bethlehem,  Penn.,  and  Vicinity  in  i88i-'82. 

9.  Hibbard,  James  F.,  M.  D. 

10.  Propositions  concerning  Vaccination. 
10.  HoLMAN,  E.  E.,  M.  D. 

n.  Stock  Transportation. 


LIST  OF  AUTHORS.  1 69 

11.  Keating,  Col.  J.  M. 

12.  The  Cremation  of  Excreta  and  Household  Refuse. 

12.  Mills,  H.  R.,  M.  D. 

13.  The  Immigrant  Inspection  Service  of  the  National  Board  of  Health  at  Port 
Huron,  Mich.,  and  its  Bearing  on  the  Public  Health  of  the  West  and  North- 
West. 

13.  Newell,  T.,  M.  D. 

14.  The   Sanitary,  Physical,  and  Educational  Advantages  of  Interior  Open-air 

Areas  in  Large  Cities. 

14.  Smith,  Joseph  R.,  M.  D. 

15.  Observations  on  Texas  Cattle,  Age, Weight,  Temperature,  Liver,  and  Spleen. 

15.  Speed,  John  J.,  M.  D. 

16.  The  Relations  of  Health  Associations  to  the  Practice  of  Medicine. 

16.  Stevens,  Thad.  M.,  M.  D. 

17.  A  History  of  Health-Work  in  Indiana. 

17.  Storer,  Horatio  R.,  M.  D. 

18.  The  Newport  (Edinburgh)  System  of  Sanitary  Protection. 

18.  Thornton,  G.  B.,  M.  D. 

19.  The  Negro  Mortality  of  Memphis. 

19.  Wight,  O.  W.,  M.  D. 

20.  Lavirs  Requiring  Medical  Men  to  Report  Deaths  and  Cases  of  Infectious  Dis- 

eases to  the  Public  Authorities. 

20.  Wilson,  T.  P.,  M.  D. 

21.  Life  on  Wheels — Its  Sanitary  Needs. 


VOL.  IX.— AUTHORS,  ALPHABETICALLY  ARRAGNED. 

1.  Belfield,  William  T.,  M.  D. 

1.  Swell-Head  in  Cattle. 

2.  DeWolf,  O.  C,  M.  D. 

2.  Pullman  from  a  State  Medicine  Point  of  View. 

3.  Ferguson,  David,  M.  D. 

3.  Preventable  Contagious  Diseases. 

4.  Foster,  Eugene,  M.  D. 

4.  Report  of  the  Committee  on  Compulsory  Vaccination;  also  a  Supplementary 

Report  on  the  Efficiency  and  Safety  of  Vaccination. 

5.  GiHON,  Albert  L.,M.D. 

5.  Vital  Statistics  as  Sanitary  Monitors. 

6.  Hargis,  R.  B.  S.,  M.  D. 

6.  The  Pensacola  Yellow  Fever  Epidemic  of  1882. 

7.  Hering,  Rudolph,  C.E. 

7.  Essential  Features  of  House  Drainage,  and  Practical  Points  regarding  its  De- 

sign and  Construction. 

8.  Janes,  E.  H.,  M.  D. 

8.  Typhus  Fever  in  New  York  City. 

9.  Leeds,  Prof.  Albert  R.,  Ph.  D. 

9.  The  Adulteration  of  Foods. 

10.  LuNDY,  Charles  J.,  A.  M.,  M.  D. 

10.  School  Hygiene. 

11.  Newton,  William  K.,  M.  D. 

11.  The  Sanitary  Control  of  the  Food-Supply. 

12.  Oldright,  William,  A.M.,  M.D. 

12.  The  Overhead  Ventilation  of  Sewers. 

13.  Partridge,  J.  M.,  A.  M.,  M.  D. 

13.  Swine  Plague,  or  Hog  Cholera. 


I70  LIST  OF  AUTHORS. 

14.  Penn,  J.  W.,  M.  D. 

14.  Interrogatories  on  Malarial  Fever. 

15.  Pratt,  Foster,  M.  D. 

15.  The  Increase  of  Insanity  in  the  United  States :  its  Causes  and  its  Sources. 

16.  Raymond,  Joseph  H.,  M.  D. 

16.  House  Sanitation. 

17.  Reeves,  James  E.,  M.  D. 

17.  The  Eminent  Domain  of  Sanitary  Science,  and  the  Usefulness  of  State 
Boards  of  Health  in  Guarding  the  Public  Welfare. 

18.  Salmon,  D.  E.,  D.V.M. 

18.  Te.\as  Cattle  Fever  :  Is  it  a  Chimera,  or  a  Reality  ? 

19.  Sargent,  Prof.  D.  A. 

19.  Physical  Training. 

20.  Smart,  Charles,  M.  D. 

20.  On  the  Prevention  of  Malarial  Diseases. 

21.  Smith,  Joseph  R.,  M.  D. 

21.  Observations  on  Texas  Cattle  :  Age,  Weight,  Temperature,  Liver,  and  Spleen. 

22.  Sternberg,  George  M.,  M.  D. 

22.  Malaria. 

23.  Watson,  Prof.  J.  Madison. 

23.  Physical  Training, 

24.  Webb,  R.  D.,  M.  D. 

24.  The  Changes  of  Type  which  Malarial  Fevers  have  Undergone  in  Sumter 

County,  Ala.,  from  1833  to  1883. 

25.  Wood,  Thomas  F. 

25.  The  Clinical  Thermometer  in  the  Prevention  of  Malarial  (Paludal)  Fever, 
especially  that  Form  of  it  to  which  Seamen  sailing  out  of  South  Atlantic 
and  Gulf  Ports  are  Liable. 

26.  WOODHULL,  A.  A.,  M.  D. 

26.  The  Etiological  Association  of  Organic  Matter  with  Malaria. 


VOL.  X.— AUTHORS,  ALPHABETICALLY  ARRANGED. 

1.  Alt,  Adolf,  M.  D. 

1.  On  Protective  Spectacles  for  Workingmen. 

2.  Baker,  Henry  B.,  M.  D. 

2.  The  Relation  of  the  Depth  of  Water  in  Wells  to  the  Causation  of  Typhoid 

Fever. 

3.  Beugless,  John  D.,  Chaplain  U.  S.  A. 

3.  Cremation  as  a  Safeguard  against  Epidemics. 

4.  Brewer,  Prof.  W.  H. 

4.  Glucose  in  its  Sanitary  Aspects. 

5.  Brooks,  Hon.  Erastus. 

5.  The  Food  we  eat,  the  Liquids  we  drink,  and  the  Adulterations  we  submit  to. 

6.  Chancellor,  C.  W.,  M.  T). 

6.  The  .Squalid  Dwellings  of  the  Poor — a  .Social  and  Sanitary  Reproach. 

7.  Conery,  W.  B.,  M.  D. 

7.  Sanitary    Care   in   .Stock  Transportation  in  the  Prevention  and  Control  of 

Texas  Cattle  Fever. 

8.  Cook,  W.  C,  M.  D. 

8.  Public  Health  and  Legislation. 

9.  Cornwall,  Prof.  H.  B. 

9.  Adulteration  of  Beer. 
10.  Curtman,  Charles  O.,  M.  D. 

10.  On  Heating  and  Ventilation  of  Dwellings  and  School-Rooms. 


LIST  OF  AUTHORS.  I/I 

11.  Davenport,  Bennett  F.,  M.  D. 

II.  Adulterations  of  Food  and  Drugs. 

12.  Elder,  E.  S.,  M.  D. 

13.  Sanitary  Survey  of  the  School-Houses  in  Indiana. 

13.  FoRMENTo,  Felix,  M.  D. 

13.  School  Hygiene. 

14.  Fry,  Frank  R.,  A.  M.,  M.  D. 

14.  The  Manufacturer  of  Soda-Water  from  Polluted  Well-Water. 

15.  Harris,  W.  John,  M.  D. 

15.  The  Chemical  Disposition  of  Sewage. 

16.  Hartwell,  Edward  Mussey,  M.  D.,  Ph.  D. 

16.  On  Physical  Training  in  the  United  States. 

17.  Herrick,  S.  S.,  M.  D. 

17.  The  Relation  between  Underground  Sewerage  and  Filth  Diseases. 

18.  Homan,  George,  M.  D. 

18.  A  Sanitary  Survey  of  St.  Louis  ;  being  a  Series  of  Short  Papers  on  Leading 
Public  Health  Topics,  contributed  by  City  Officials  and  Local  Sanitarians. 

19.  The    Situation,    Surroundings,   and   Soil  of  St.   Louis.    Considered  from  a 

Hygienic  Standpoint. 

20.  The  Leading  Local  Productive  Industries,  and  their  Effect  on  the  Health 

and  Lives  of  their  Operatives. 

19.  Keating,  J.  M. 

21.  The  Ultimate  of  Sanitation  by  Fire. 

20.  LuEDEKiNG,  Robert,  M.  D. 

22.  The  Chief  Local  Factors  in  the  Causation  of  Disease  and  Death. 

21.  Moore,  Robert,  C.  E. 

23.  Sewerage  and  House  Drainage  in  St.  Louis. 

24.  Notes  upon  the  History  of  Cholera  in  St.  Louis. 

22.  Morris,  J.  Cheston,  M.  D. 

25.  The  Milk-Supply  of  our  Large  Cities — The  Extent  of  Adulteration  and  its 

Consequences — Methods  of  Prevention. 

23.  MuNROE,  Prof.  Charles  E.,  U.  S.  N.  A. 

26.  The  Use  of  Cotton-Seed  Oil  as  Food  and  for  Medicinal  Purposes. 

24.  NEVi^TON,  William  K.,  M.  D. 

27.  The  Sanitary  Survey  of  a  House. 

25.  Nipher,  Prof.  F.  E. 

28.  The  Mean  Temperature  and  Climatic  Conditions  of  St.  Louis. 

26.  Parker,  W.  Thornton,  M.  D. 

29.  The  Sanitary  Management  of  Railway  Cars  and  Stations. 

27.  Partridge,  J.  M.,  A.  M.,  M.  D. 

30.  Protection  against  Plydrophobia. 

28.  Reeves,  James  E.,  M.  D. 

31.  Pollution  of  the  Upper  Ohio,  and  the  Water-Supply  of  the  Cities  and  Chief 
Towns  within  the  first  Five  Hundred  Miles  of  its  Course. 

29.  RiCHEY,  S.  O.,  M.  D. 

32.  Deterioration  of  Vision  in  School  Children. 

30.  Robinson,  Major  Samuel  A. 

33.  Hygiene  of  the  Habitations  of  the  Poor. 

31.  RoHE,  George  PL,  M.  D. 

34.  The  Hygiene  of  Occupations. 

32.  Smart,  Charles,  M.  D. 

35.  On  the  Present  and  Future  of  Sanitary  Water  Analysis. 

33.  Spiegelhalter,  Joseph,  M.  D. 

36.  The  Local  Milk-Supply — Its  Sources  and  Quality. 

34.  Sternberg,  George  M.,  M.  D. 

'^'].  Disease  Germs. 


1/2  LIST  OF  AUTHORS. 

35.  Stevens,  Thad.  M.,  M.  D. 

38.  The  True  Value  of  Chemical  Analysis   in  Determining  the  Hygienic  Purity 

of  Potable  Water. 

36.  Stevenson,  John  U.,  Esq. 

39.  Organization  of  Health  Department,  Sanitary  Legislation,  and  the  Abate- 

ment of  Nuisances. 

37.  Thornton,  G.  B.,  M.  D. 

40.  Sanitation  of  the  Mississippi  Valley. 

38.  Turner,  John  W.,  C.  E. 

41.  Street  and  Alley  Paving  in  St.  Louis. 

39.  Vaughan,  V.  C  .,  M.  D. 

42.  Poisonous  or  "  Sick"  Cheese. 

40.  ViNNEDGE,  W.  W.,  M.  D. 

43.  On  the  Duration  of  Infectiousness  in  Scarlet  Fever. 

41.  Waring,  George  E.,  Jr.,  C.  E. 

44.  The  Disposal  of  Sewage. 

42.  Whitman,  Thomas  J.,  C.  E. 

45.  The  Public  Water-Supply  of  St.  Louis. 

43.  Wyman,  W.,  M.  D. 

46.  Hardships  of  the  Coasting  Trade,  and  Particularly  of  the  Chesapeake  Bay 
Oystermen. 


Total  number  of  different  authors, 222 

*Total  number  of  papers  contributed, 335 

*  The  Reports  of  Committees  and  Delegations,  four  in  number,  in  the  above  list,  are  not  in- 
cluded in  this  totaL 


CONSTITUTION 

OF    THE 

AMERICAN  PUBLIC  HEALTH  ASSOCIATION. 


TITLE. 

I.  This  Association  shall  be  called  "  The  American  Public  Health 
Association." 

objects. 

II.  The  objects  of  this  Association  shall  be  the  advancement  of  sanitary 
science  and  the  promotion  of  organizations  and  measures  for  the  practical 
application  of  public  hygiene. 

MEMBERS. 

III.  The  members  of  this  Association  shall  be  known  as  Active  and 
Associate.  The  Executive  Committee  shall  determine  for  which  class  a 
candidate  shall  be  proposed.  The  Active  members  shall  constitute  the 
permanent  body  of  the  Association,  subject  to  the  provisions  of  the  con- 
stitution as  to  continuance  in  membership.  They  shall  be  selected  with 
special  reference  to  their  acknowledged  interest  in  or  devotion  to  sani- 
tary studies  and  allied  sciences,  and  to  the  practical  application  of  the 
same.  The  Associate  members  shall  be  elected  with  special  reference 
to  their  general  interest  only  in  sanitary  science,  and  shall  have  all  the 
privileges  and  publications  of  the  Association,  but  shall  not  be  entitled 
to  vote. 

Delegates  from  national,  state,  provincial,  and  municipal  boards  of 
health,  organized  sanitary  associations,  and  the  army,  navy,  and  marine 
hospital  service,  shall  be  entitled  to  be  enrolled  as  active  members  upon 
presentation  of  their  credentials  to  the  Executive  Committee.  Members, 
not  delegates  from  such  bodies  shall  be  elected  as  follows  : — 

Each  candidate  for  admission  shall  first  be  proposed  to  the  Executive 
Committee,  in  writing  (which  may  be  done  at  any  time),  with  a  state- 
ment of  the  business  or  profession  and  special  qualifications  of  the  per- 
son so  proposed.  On  recommendation  of  a  majority  of  the  committee, 
and  on  receiving  a  vote  of  two  thirds  of  the  members  present  at  a  reg- 
ular meeting,  the  candidate  shall  be  declared  duly  elected  a  member 
of  the  Association.  The  annual  fee  of  membership  in  either  class  shall 
be  five  dollars. 


174  CONSTITUTION. 


OFFICERS. 

IV.  The  officers  shall  be  a  President,  a  First  and  Second  Vice-Presi- 
dent, a  Secretary,  and  a  Treasurer. 

All  the  officers  shall  be  elected  by  ballot,  annually,  except  the  Secreta- 
ry, who  shall  be  elected  for  a  term  of  three  years. 

PRESIDING    OFFICER. 

V.  The  President,  or  in  his  absence,  one  of  the  Vice-Presidents,  or 
in  their  absence,  a  Chairman  fro  teTHpore.^  shall  preside  at  all  meetings 
of  the  Association.  He  shall  preserve  order,  and  shall  decide  all  ques- 
tions of  order,  subject  to  appeal  to  the  Association.  He  shall  also 
appoint  all  committees  authorized  by  the  Association,  unless  otherwise 
specially  ordered. 

SECRETARY. 

VI.  The  Secretary  shall  have  charge  of  the  correspondence  and  rec- 
ords of  the  Association  ;  and  he  shall  also  perform  the  duties  of  Libra- 
rian. He,  together  with  the  presiding  officer,  shall  certify  all  acts  of  the 
Association,  He  shall,  under  the  direction  of  the  Executive  Committee, 
give  due  notice  of  the  time  and  place  of  all  meetings  of  the  Association, 
and  attend  the  same.  He  shall  keep  fair  and  accurate  records  of  all  the 
proceedings  and  orders  of  the  Association  ;  and  shall  give  notice  to  the 
several  officers,  and  to  the  Executive  and  other  Committees,  of  all  votes, 
orders,  resolves,  and  proceedings  of  the  Association,  affecting  them  or 
appertaining  to  their  respective  duties. 

TREASURER. 

VII.  The  Treasurer  shall  collect  and  take  charge  of  the  funds  and 
securities  of  the  Association.  Out  of  these  funds  he  shall  pay  such  sums 
only  as  may  be  ordered  by  the  Association,  or  by  the  Executive  Commit- 
tee. He  shall  keep  a  true  account  of  his  receipts  and  payments  ;  and, 
at  each  annual  meeting,  render  the  same  to  the  Association,  when  a 
committee  shall  be  appointed  to  audit  his  accounts.  If  from  the  annual 
report  of  the  Treasurer  there  shall  appear  to  be  a  balance  against  the 
treasury,  no  appropriation  of  money  shall  be  made  for  any  object  but  the 
necessary  current  expenses  of  the  Association,  until  such  balance  shall 
be  paid. 

STANDING    COMMITTEES. 

VIII.  There  shall  be  the  following  standing  committees:  (i)  The 
Executive  Committee,  (2)  the  Advisory  Council,  (3)  the  Committee  on 
Publication. 

EXECUTIVE    COMMITTEE. 

IX.  The  Executive  Committee  shall  consist  (i)  of  the  President,  First 
Vice-President,  Second  Vice-President,  Secretary,  and  Treasurer  ;  (2)  of 
six  active  members,  of  whom  three  shall  be  elected  annually  by  ballot,  to 


CONSTITUTION.  175 

serve  two  years,  and  who   shall  be  ineligible  to  reelection  for  a  second 
successive  term  ;  and  (3)  of  the  ex-Presidents  of  the  Association. 

It  shall  be  the  duty  of  the  Executive  Committee  to  consider  and  recom- 
mend plans  for  promoting  the  objects  of  the  Association  ;  to  authorize 
the  disbursement  and  expenditure  of  unappropriated  moneys  in  the 
treasury  for  the  payment  of  current  expenses  ;  to  consider  all  applications 
for  membership,  and,  at  the  regular  meetings,  report  the  names  of  such 
candidates  as  a  majority  shall  approve  ;  and,  generall}^,  to  superintend 
the  interests  of  the  Association,  and  execute  all  such  duties  as  may,  from 
time  to  time,  be  committed  to  them  by  the  Association.  At  least  one 
month  preceding  the  annual  meeting  of  the  Association,  the  Executive 
Committee  shall  cause  to  be  issued  to  members  a  notice  of  such  meeting, 
and  they  are  authorized  to  publish  the  same  in  medical,  scientific,  and 
other  periodicals,  but  without  expense  to  the  Association  ;  and  such  notice 
shall  contain  the  order  of  business  to  be  followed  at  said  meeting,  and, 
briefly,  the  subjects  to  be  presented,  and  the  special  points  of  discussion. 

ADVISORY   COUNCIL. 

X.  The  Advisory  Council  shall  consist  of  one  member  from  each  State, 
Territory,  and  District,  the  Army,  Navy,  and  Marine  Hospital  Service,  the 
Dominion  of  Canada,  and  each  of  the  Provinces,  who  shall  be  appointed 
by  the  President  on  the  last  day  of  each  session,  and  who,  besides  acting 
as  a  nominating  committee  of  officers  for  the  ensuing  year,  to  be  an- 
nounced at  such  time  as  the  Executive  Committee  may  appoint,  shall 
consider  such  questions  and  make  such  recommendations  to  the  Associa- 
tion as  shall  best  secure  the  objects  of  the  Association.  They  shall  at 
their  first  meeting  elect  from  their  own  number  a  Secretary,  whose  rec- 
ord of  their  proceedings  shall  be  made  part  of  the  records  of  the  Associa- 
tion, 

COMMITTEE    ON    PUBLICATION. 

XI.  The  Committee  on  Publication  shall  consist  of  the  Secretary  and 
two  active  members,  selected  by  the  Executive  Committee,  who  shall 
contract  for,  arrange,  and  publish,  under  authority  of  the  Executive 
Committee,  the  proceedings  of  the  Association,  including  such  papers  as 
have  been  examined  and  approved  by  the  Executive  Committee,  or  which 
have  been  submitted  to  them  by  the  latter  for  their  discretionary  action. 

REPORTS   AND    PAPERS. 

XII.  All  committees,  and  all  members  preparing  scientific  reports  or 
papers  to  be  laid  before  the  Association  at  its  annual  meetings,  must 
give,  in  writing,  the  title  of  such  reports  or  papers,  the  time  to  be  occu- 
pied in  reading  them,  and  an  abstract  of  their  contents,  to  the  Executive 
Committee,  at  least  one  week  preceding  the  date  of  such  meeting,  to  se- 
cure their  announcement  in  the  order  of  business. 


176  CONSTITUTION. 

MEETINGS. 

XIII.  The  time  and  place  of  each  annual  meeting  shall  be  fixed  at  the 
preceding  annual  meeting,  but  may  be  changed  by  the  Executive  Com- 
mittee for  reasons  that  shall  be  specified  in  the  announcement  of  the 
meeting.  Special  meetings  may  be  called,  at  any  time  or  place,  by  con- 
currence of  two  thirds  of  the  Executive  Committee.  There  shall  be  no 
election  of  officers,  or  change  of  By-laws,  or  appropriation  of  money  to 
exceed  the  amount  at  that  time  in  the  treasury,  at  such  special  meeting, 
except  by  a  vote  of  a  majority  of  all  the  members  of  the  Association. 
Whenever  a  special  meeting  is  to  be  held,  at  least  one  month's  notice 
shall,  if  possible,  be  given  by  circular,  to  all  the  members,  together  with 
the  order  of  business. 

QUORUM. 

XIV.  At  the  annual  meeting  nine  members  shall  constitute  a  quorum 
for  the  election  of  officers,  a  change  of  the  Constitution,  the  election  of 
members,  and  the  appropriation  of  moneys. 

ORDER    OF   BUSINESS. 

XV.  The  order  of  business  at  all  meetings  of  the  Association  shall  be 
fixed  by  the  Executive  Committee,  and  such  order  must  be  completed 
before  any  other  business  is  introduced,  except  such  order  of  business  is 
suspended  by  a  vote  of  four  fifths  present. 

ALTERATION    OF    CONSTITUTION. 

XVI.  No  alteration  in  the  Constitution  of  the  Association  shall  be 
made  except  at  an  annual  meeting,  nor  unless  such  alteration  shall  have 
been  proposed  at  a  previous  meeting,  and  entered  on  the  minutes  with 
the  name  of  the  member  proposing  the  same,  and  shall  be  adopted  by  a 
vote  of  two  thirds  of  the  members  present. 


OFFICERS  AND   COMMITTEES 


AMERICAN    PUBLIC    HEALTH    ASSOCIATION. 


Organization,  1885-1J 


President, 

First  Vice-President, 

Second  Vice-President, 

Secretary, 

Treastcrer, 


Dr.  Henry  P.  Walcott,     . 
Dr.  Charles  W.  Covernton, 
Dr.  G.  B.  Thornton, 
Dr.  Irving  A.  Watson, 
Dr.  J.  Berrien  Lindsley,  . 

{Ex-officzo  Members  Executive  Committee.) 


Cafnbridge,  Mass. 
Toronto,  Out. 
.  Metnphis,  Tenn, 
.  Concord,  N.  H. 
.  Nashville,  Tenn. 


STANDING  COMMITTEES. 
executive  committee. 

(Elective.) 

Major  Charles  Smart,  U.  S.  A Washington,  D.  C. 

Dr.  Henry  B.  Baker Lansing,  Mich. 

Dr.  Pinckney  Thompson Henderson,  Ky. 

Prof.  HosMER  A.  Johnson Chicago,  III. 

Dr.  Joseph  Holt New  Orleans,  La. 

Prof.  Charles  N.  Hewitt Red  Wing,  Minn. 

(The  ex-Presidents,  ex-qfficio  members  Executive  Committee.) 

Dr.  Stephen  Smith New  York  city. 

Dr.  Joseph  M.  Toner Washington,  D.  C. 

Dr.  Edwin  M.  Snow Providence,  R.  I. 

Dr.  John  H.  Rauch Springfield,  III. 

Prof.  James  L.  Cabell University  of  Virginia,  Va. 

Dr.  John  S,  Billings U.S.  Army. 

Prof.  Robert  C.  Kedzie Lansing,  Mich. 

Dr.  Ezra  M.  Hunt Trenton,  N.  J. 

Dr.  Albert  L.  Gihon U.S.  Navy. 

Dr.  James  E.  Reeves Wheeling,  W.  Va. 


Alabama,  . 
Arkansas,  . 
California, 
Colorado,  . 
Connecticut, 
Delaware, . 


ADVISORY    council. 

The  President,  ex-ojficio. 

Dr.  Jerome  Cochran,  Mobile. 
Dr.  H.  C.  Dunavant,  Osceola. 
Dr.  G.  G.  Tyrrell,  Sacramento. 
Dr.  Charles  Ambrook,  Boulder. 
Prof.  C.  A.  Lindsley,  New  Haven. 
Dr.  L.  P.  Bush,  Wilmington. 


1/8 


LIST  OF  OFFICERS. 


Florida, 

Georgia,    . 

Illinois, 

Indiana,     . 

Iowa, 

Kentucky, 

Louisiana, 

Maine, 

Maryland, 

Massachusetts, 

Michigan,  . 

Minnesota, 

Mississippi, 

Missouri,    . 

New  Hampshire, 

New  Jersey, 

New  York, 

North  Carolina, 

Ohio, 

Pennsylvania, 

Rhode  Island, 

South  Carolina, 

Tennessee, 

Texas, 

Vermont, 

Virginia, 

West  Virginia, 

Wisconsin, 

Dist.  of  Columbia, 

U.  S.  Army, 

U.  S.  Navy, 

U.  S.  M.  H.  Service, 

Domin.  of  Canada, 

Prov.  of  Ontario, 

Prov.  of  Quebec, 


Dr.  Robert  B.  S.  Hargis,  Pensacola. 

Dr.  W.  H.  Elliott,  Savannah. 

Dr.  John  H.  Rauch,  Springfield. 

Dr.  C.  N.  Metcalf,  India7iapolis. 

Dr.  J.  F.  Kennedy,  Des  Moines. 

Dr.  William  Bailey,  Louisville. 

Dr.  Gustavus  Devron,  New  Orleans. 

Dr.  Frederic  H.  Gerrish,  Portland. 

Prof.  George  H.  Rohe,  Baltimore. 

Dr.  S.  H.  DuRGiN,  Boston. 

Dr.  O.  W.  Wight,  Detroit. 

Dr.  D.  W.  Hand,  .5"/.  Paid. 

Dr.  Wirt  Johnston,  Jackson. 

Dr.  Joseph  Spiegelhalter,  St.  Louis. 

Dr.  George  Cook,  Concord. 

Dr. William  K.  Newton,  Paterson. 

Dr.  A.  Nelson  Bell,  A^ew  York  city. 

Dr.  Thos.  F.  Wood,  Wihnington. 

Dr.  R.  Harvey  Reed,  Mansfield. 

Dr.  Benjamin  Lee,  Philadelphia. 

Dr.  Chas.  H.  Fisher,  Providence. 

Dr.  Henry  B.  Horlbeck,  Charleston. 

Dr.  Charles  Mitchell,  Nashville. 

Dr.  R.  M.  Sweringen,  Atistin. 

Hon.  Henry  D.  Holton,  Brattleboro* 

Dr.  J.  F.  Winn,  Richmoftd. 

Dr.  C.  T.  Richardson,  Charlestown. 

Dr.  J.  T.  Reeve,  Appleton. 

Dr.  Smith  Townshend,  Washington. 

Surgeon  John  S.  Billings,  Washington,  D.  C. 

Medical  Director  Albert  L.  Gihon,  Washington,  D.  C. 

Surgeon  Preston  H.  Bailhache,  Washington,  D.  C. 

Dr.  W.  H.  Hingston,  Montreal,  P.  Q. 

Dr.  Peter  H.  Bryce,  Toronto. 

Dr.  F.  Montizambert,  Quebec. 


publication  committee. 


The  Secretary,  ex-officio. 


Dr.  Samuel  H.  Durgin 
Dr.  Granville  P.  Conn 


Boston,  Mass. 
Concord,  N.  H. 


SECTION   OF   STATE   BOARDS   OF   HEALTH. 

(Created  at  last  meeting;    organization  to  be  made  at  Toronto.) 


SPECIAL  COMMITTEES. 

ON  STATE  boards  OF  HEALTH. 

Dr.  Charles  N.  Hewitt,  Secretary  State  Board  of  Health  of  Minnesota. 
Dr.  Ezra  M.  Hunt,  Secretary  State  Board  of  Health  of  New  Jersey. 
Dr.  Frederic  H.  Gerrish,  President  State  Board  of  Health  of  Maine. 


LIST  OF  OFFICERS.  1/9 

Dr.  J.  T.  Reeve,  Secretary  State  Board  of  Health  of  Wisconsin. 

Dr.  Joseph  Holt,  President  State  Board  of  Health  of  Louisiana. 

Dr.  Thomas  F.  Wood,  Secretary  State  Board  of  Health  of  North  Carolina. 

Dr.  C.  N.  Metcalf,  Secretary  State  Board  of  Health  of  Indiana. 

Dr.  G.  G.  Tyrrell,  Secretary  State  Board  of  Health  of  California. 

Dr.  Peter  H.  Bryce,  Secretary  Provincial  Board  of  Health  of  Ontario. 

ON   SCHOOL    HYGIENE. 

Prof.  Edward  M.  Hartwell Baltimore,  Md. 

Prof.  D.  A.  Sargent Cambridge,  Mass. 

Dr.  Samuel  W.  Abbott Wakefield,  Mass. 

Prof.  J.  Madison  Watson Elizabeth,  N.  J. 

Dr.  Felix  Formento New  Orleans,  La. 

Note.     The  chairman  is  authorized  to  appoint  an  additional  member  from  each  state,  province,  etc. 
ON   ANIMAL   DISEASES   AND   ANIMAL   FOODS. 

Dr.  D.  E.  Salmon,  V.  S Washington,  D.  C. 

Dr.  J.  M.  Partridge South  Bend,  Ind. 

Dr.  Ezra  M.  Hunt Trenton,  N.  J. 

Prof.  James  Law Ithaca,  N.  Y. 

Dr.  Charles  W.  Chancellor Baltimore,  Md. 

Dr.  John  H.  Rauch Springfield,  111. 

Dr.  D.  W.  Hand St.  Paul,  Minn. 

Lt.  Col.  Joseph  R.  Smith,  U.  S.  A San  Antonio,  Tex. 

Dr.  W.  B.  Conery St.  Louis,  Mo. 

ON   disposal   of   THE    DEAD. 

Dr.  John  Morris Baltimore,  Md. 

Rev.  John  D.  Beugless,  U.  S.  N Brooklyn,  N.  Y. 

Dr.  Felix  Formento New  Orleans,  La. 

Dr.  James  F.  Hibberd Richmond,  Ind. 

Dr.  A.  N.  Bell New  York  city. 

Dr.  William  Bailey Louisville,  Ky. 

Prof.  George  H.  Rohb • Baltimore,  Md. 

ON  disinfectants. 

Maj.  George  M.  Sternberg,  U.  S.  A Ba'timore,  Md. 

Prof.  George  H.  Rohb Baltimore,  Md. 

Maj.  Charles  Smart,  U.  S.  A Washington,  D.  C. 

Prof.  V.  C.  Vaughan Ann  Arbor,  Mich. 

Dr.  Joseph  H.  Raymond Brooklyn,  N.  Y. 

Dr.  Joseph  Holt New  Orleans,  La. 

Dr.  Samuel  H.  Durgin Boston,  Mass. 

ON  disinfection  of  rags. 

Dr.  J.  Howard  Taylor Philadelphia,  Penn. 

Dr.  A.  N.  Bell New  York  city. 

Dr.  Henry  B.  Baker     .     .     .     .  • Lansing,  Mich. 

Dr.  Charles  W.  Chancellor Baltimore,  Md. 


l80  LIST  OF  OFFICERS. 

Dr.  Henry  B.  Horlbeck Charleston,  S.  C. 

Dr.  Joseph  H.  Raymond Brooklyn,  N.  Y. 

Dr.  Joseph  Holt New  Orleans,  La. 

ON    ANTISEPTICS    IN    VACCINATION. 

Dr.  Thomas  F.  Wood Wilmington,  N.  C. 

Dr.  Samuel  W.  Abbott Wakefield,  Mass. 

Dr.  D.  E.  Salmon,  V.  S Washington,  D.  C. 

on  incorporation. 

Dr.  Hexry  p.  Walcott,  President Camoridge,  Mass. 

Dr.  Irving  A.  Watson,  Secretary Concord,  N.  H. 

Dr.  J.  Berrien  Lindsley,  Treasurer Nashville,  Tenn. 

Medical  Director  Albert  L.  Gihon,  U.  S.  N Washington,  D.  C. 

Major  Charles  Smart,  U.  S.  A Washington,  D.  C. 

Hon.  John  Eaton Washington,  D.  C. 

Dr.  Smith  Townshend Washington,  D.  C. 

Samuel  A.  Robinson,  Esq Washington,  D.  C. 

ON  NECROLOGY. 

The  Secretary. 


INDEX. 


A 

Page, 

Acid,  carbolic  (see  carbolic) 

Accidents  in  oiling  machinery 148 

provisions  against,  in  handling  goods 148 

provisions  for,  in  factories            .         .        .         .        .        .         .        .        •  151 

Affections  of  the  nervous  system 94 

Air,  amount  of  carbonic  acid  in 73 

and  cubic  space  required,  amount  of,  in  school-rooms 72 

and  sunlight  should  be  admitted 7 

cubic  feet  per  minute  for  pupils     .         . 71 

ducts  for  furnaces 80 

foul,  escape  of,  how  provided  for 10 

how  removed 71 

fresh,  and  cubic  space  required,  different  authorities  on 72 

do  children  require  a  smaller  amount  than  adults  ? 73 

heating  of      .         .         .         .         .         .         .         .         ,         .         .         .        -71 

how  introduced 71 

Parkes  and  De  Chaumont  on 'J'^ 

in^coming,  velocity  of 71 

inoffensive  to  the  sense  of  smell  may  be  unhealthful 103 

proper  position  for  outlets  and  inlets  for 79 

supply,  source  of 80 

Albumens  or  proteids 24 

Animal  foods 33 

food  necessary 26 

vapors  from  skin  and  lungs  more  dangerous  than  carbonic  acid  gas     .         .  79 

Anthrax  bacilli  destroyed  by  sulphurous  acid  gas 112 

destroyed  by  mercuric  chloride ill 

Davaine's  experiments  with  the  blood  of 105 

Antiseptics loi 

all  are  not  germicides 108 

not  necessarily  disinfectants .  102 

retard  the  development  of  bacteria 108 

useful,  when 108 

Arrow-root 55 

qualities  of  good 55 

Arsenic  frequently  found  in  wall-papers 5 

Ashes,  how  to  dispose  of  in  factories 145 

B 

Bacilli 107 

Bacon,  pork,  and  ham .38 

Bacteria         . 106 

agents  may  arrest  multiplication  and  not  destroy 108 

description  of 106 

multiplication  of 107 


1 82  INDEX. 

Baking-powders jr 

Barley 50 

Bath-room,  cost  of 7 

how  heated 7 

how  supplied  with  water 7 

Beans  and  pease 53 

composition  of ej 

food  value  of 54. 

Bedding,  disinfection  of 116 

Bed-rooms,  attic,  not  recommended •         .  6 

basement,  always  poorly  supplied  with  fresh  air       .         .         .         .         .  6 

unhealthy 4 

should  not  be  small 6 

Beef,  classification  of  according  to  quality 37 

composition  of 37 

rules  governing  the  selection  of 34. 

Beef-tea,  how  made        . 41 

Beets 24 

Belgium,  amount  of  air  allowed  pupils  in 72 

Benzine,  dangers  from 146 

Billings,  Dr.,  "  Ventilation  and  Heating,"  illustrations  from 82 

on  the  amount  of  fresh  air  required  for  school  children          ...  73 

Blinds,  how  constructed  for  school-rooms 92 

Boiling  as  a  disinfectant no 

Bone  and  cartilage 41 

Books,  effect  of,  upon  eyesight 91 

Boston,  cubic  space  allowed  pupils  in  schools  of 72 

Bread 51 

adulteration  of 52 

amount  of  water  in 25 

changes  on  standing 52 

essential  constituents  of 51 

good,  general  properties  of 52 

raising  by  aeration 52 

by  baking-powders 51 

by  the  growth  of  yeast 51 

stale 52 

the  food  value  of 53 

Brick,  absorption  of  water  by 5 

houses  damp  unless  properly  constructed 5 

Bridgeport,  Conn.,  high  school,  temperature  of  rooms         .         .        .        .        .         •  77 

ventilation  of  rooms 77 

Brussels,  medical  supervision  of  schools  in 97 

Buckwheat,  composition  of 50 

"Bug-poison" til 

Butter .  45 

amount  of  casein  permissible  in 46 

composition  of 45 

how  to  take  care  of 46 

physical  properties  of 45 

Butterine  and  oleomargarine 46 

o 

Cabbage ^4 

Caffeine 61 

Carbo-hydrates  and  starches 25 


INDEX.  183 

Carbolic  acid  as  a  disinfectant     ......<...,  113 

in  cholera ■         ,         .         ,115 

not  destructive  to  spores 107 

special  uses  of .         .       115,  116,  118,  119 

Carbonic  acid  gas,  amount  exhaled  at  different  ages  .      ' 73 

amount  of,  in  the  air      .         .         ■                 •         •                 •         -  73 

not  specially  dangerous  in  quantities  found  in  school-rooms         .  79 
tables  showing  amount  observed  in  different  American  and 

foreign  schools 79 

test  for 80 

Carpets  objectionable »        •  5 

Carrots ...  54 

Cartilage  and  bone        .....                 41 

Caseine 42 

Cellar  floor,  how  made  damp-proof 66 

should  be  of  concrete 4 

how  constructed  for  tenement-houses ,        .  22 

school-house,  should  be  guarded  against  contamination           ....  66 

should  be  free  from  dampness  and  ground-air '       .  4 

well  supplied  with  light 4 

stairs  should  lead  from  the  kitchen  or  pantry 7 

wall,  how  made 4,  5 

windows,  how  arranged 4 

Cereals  and  grains 48 

Cesspools,  disinfection  of 119 

how  constructed 17 

when  admissible .         .84 

Chairs  for  school-rooms,  how  made  in  Germany 92 

improperly  constructed  for  school  children 93 

Charbon,  experiments  regarding 105 

Charms  to  prevent  disease 104 

Cheese 47 

how  colored 48 

in  small  amounts  aids  digestion        .         .         .        .         .        .        .        .        •  47 

Chloride  of  lime  (See  Lime,  chloride  of). 

nutritive  value  of       ... 47 

Chocolate 62 

a  very  mild  stimulant 62 

how  adulterated 62 

Cholera 126 

advice  to  the  public  regarding 125 

and  the  intemperate "  126 

and  unsanitary  conditions 126 

at  sea 121 

best  disinfectant  in 113 

clothing  in  connection  with 129 

disinfection  in 114,  116,  119 

of  body  after  death        .' 115 

drinks  that  may  be  used  during  its  prevalence         .         .        .        .         .        .128 

epidemics  of,  call  for  courageous  assistants 124 

food  in  connection  with 128 

from  infected  drinking-water 126 

fruits  to  be  avoided  in 128 

germ  does  not  form  spores 108 

infectious  material  should  be  destroyed  in  the  sick-room       ....  108 

important  to  disinfect  excreta  in 114 

personal  habits  in  connection  with .        .128 


1 84  INDEX. 

Cholera,  risk  to  attendants  over-estimated .        •        .  127 

sanitary  precautions  against .  128 

should  one  flee  from  it 127 

sick-room  precautions       ...........  127 

spread  by  impure  drinking-water     .         .         . 12 

water  infected  with,  easily  disinfected I2i 

Cistern,  how  constructed 12 

material  to  be  used  in  the  construction  of 12 

overflow  trap  should  be  trapped 13 

should  not  connect  with  any  receptacle  of  filth      ...*..  13 

should  be  cleansed  at  least  once  a  year           .......  13 

should  not  be  built  under  the  house 13 

ventilation  of .  12 

water  (See  Water).  / 

Classes,  size  of,  in  schools 72 

Cleanliness  should  be  the  watchword 19 

Closets,  dry-earth,  how  made l5 

Clothing,  disinfection  of ,..ll6 

Cloths  used  in  infectious  diseases  should  be  burned 115 

Coal,  gases  given  off  in  burning            8 

Cocoa ^2 

Coffee 01 

Colostrum ..4^ 

Condiments ^8 

Confectionery 56 

adulteration  of 56 

Consumption  (See  Tuberculosis). 

from  unhealthy  house  sites 3 

tubercular,  in  schools 65 

Contag.on,  how  spread  by  pupils .  96 

Contagious  diseases  in  schools 96 

Copper,  sulphate  of 113 

special  uses 115 

Corn,  composition  of 49 

meal,  qualities  of 50 

Corrosive  sublimate  (See  Mercuric  chloride). 

as  a  disinfectant iii 

Cottages,  advantages  of 6 

Courage  no  protection  against  infection .        .124 

Crab,  value  of 40 

Cubic  space  and  fresh  air  required,  different  authorities  on 72 

Cultures,  germ,  how  to  start 106 

pure,  a  test  for  chemical  agents 106 

Curtains  for  school-rooms 92 

Cysticerci  develop  tape-worms •        •        •        •        •  39 

D 

Dandelion 54 

Davaine's  experiments  with  the  blood  of  anthrax 105 

Decomposition  due  to  "  germs" loz 

Deformities  from  school-room  life >  93 

Deodorants loi 

and  disinfectants  not  synonymous  terms 103 

in  the  sick-room 118 

when  useful 108 

Desks,  school-room,  how  made    . 93 

sizes  required 93 


INDEX.  185 

DiarrhcKa  caused  by  drinking  hard  water jj 

Digestive  organs,  comparative  weight  of 26 

Diphtheria j-j^ 

adults  less  susceptible  to,  than  children 104 

and  filth 1-14 

avoidance  of 1^4 

disinfection  in 117 

germ  of 134 


how  communicated 


134 


infection  from 134 

predisposing  causes  of 1-74 

spread  by  impure  drinking-water 12 

Diseases,  contagious,  rules  to  prevent  spread  of,  in  schools 96 

a  shop  danger 152 

how  caused  by  insulificient  pure  air 6 

infectious,  how  contracted 124 

from  micro-organisms 106 

individual  prophylaxis  against 124 

in  hospitals  should  be  isolated 121 

special  precautions  in lie 

power  to  resist,  lowered  by  foul  emanations          .         .         .         .         .        .  102 

Disinfectants  and  deodorants  not  synonymous  terms 103 

for  privies 87 

Labarraque's   . .         .110 

Littre's  definition  of 103 

some  proprietary,  untrustworthy .  102 

tested  by  "  pure  cultures" 107 

which  are  effective  in  the  absence  of  spores log 

which  have  the  power  to  destroy  spores 109 

Disinfecting  solution iii 

Disinfection 109 

and  disinfectants,  Vallin  on ,         .103 

and  individual  prophylaxis  against  infectious  diseases   ....  loi 

'                     cloths  used  in  infectious  diseases  should  be  burned         .         .         .         •  115 

definition  of      . loi 

evidence  of  no  value  often  received  .         .         .         .         .         .         .104 

general  directions  for .         '113 

in  cholera .  113 

inoculation,  experiments  regarding 105 

negative  evidence  received  with  caution 104 

object  of loi 

of  body  after  death  from  cholera 115 

of  clothing  and  bedding 116 

excreta,  etc 114 

merchandise 123 

person 115 

privy  vaults,  cesspools,  etc 119 

rags 123 

ships 121 

sick-room 118 

vacated 119 

water  and  articles  of  food 121 

popular  understanding  of lor 

something  more  than  the  destruction  of  poisonous  ptomaines         .         .  102 

special  means  resorted  to 104 

tests  of 104 

valueless  attempts  at .         .105 


1 86  INDEX. 

Disinfection,  what  it  consists  of lo8 

with  boiling  water .110 

carbolic  acid 113 

chloride  of  lime no 

chloride  of  zinc .         .  113 

dry  heat 112,117 

fire 109 

liquor  sodcc  chlorinates        .         .         .         .         .         .         .         .         .110 

mercuric  chloride  (bichloride  of  mercury,  corrosive  sublimate)      .  in 

steam  under  pressure .110 

sulphate  of  copper 113 

sulphur  dioxide  (sulphurous  acid  gas,  sulphur)       .        .         .         .112 

Doctors,  erroneous  notions  regarding  their  immunity  from  disease     ....  124 

Doors,  glass  sliding,  for  school-rooms 68 

school-house,  should  swing  outward '       .         .        .70 

Drains,  brick,  in  cellar  always  bad 20 

earthen,  broken  by  settling 21 

Drainage  of  house-site 3 

rules  governing 83 

Dress,  superfluities  of,  should  be  taught  in  school-room 93 

Dry  heat  as  a  disinfectant 112,  116 

Dust,  classification  of 147 

mechanical,  difficult  to  manage 147 

removal  of,  by  air-blast 147 

Dysentery  spread  by  impure  drinking-water 12 

E 

Earth-closets  for  school-houses 87 

Electric-light  lines  should  not  touch  buildings 146 

Elevators 140 

freight,  dangers  from 141 

gong,  signal  for 140 

responsible  person  should  run 140 

should  have  safety  locking  attachment 140 

well,  how  constructed 140 

Engine,  before  starting,  notice  should  be  given 148 

Epilepsy  from  gymnastics 95 

precautions  against .  17 

Eggs 48 

composition  of 48 

how  to  preserve 48 

Erysipelas,  disinfection  in 117 

to  be  guarded  against  in  hospitals 120 

Excreta,  etc.,  disinfection  of 114 

Exercise  for  school  children,  object  of 94 

Eyes,  affections  from  school-room  causes 88 

hygiene  of  the       .............  88 

of  school  children  examined  in  different  localities 88 

rules  for  using  the 89 

Factory,  building  of  a 139 

buildings  should  be  on  well  drained  land 139 

construction  of  a     .  ■ 139 

doors,  construction  of 140 

heating  of  a 144 


INDEX.  187 

Factory,  employes  should  organize  mutual  relief  associations 151 

fire-escapes  for 141 

offices  should  be  connected  by  speaking-tube  with  the  different  de- 
partments     142 

well  and  poorly  conducted,  difference  between 148 

Fats 25 

amount  required  per  day 25 

per  cent,  of  water  in 33 

Fear,  from  its  depressing  effect,  invites  disease 125 

Feet  of  pupils  should  be  supported 92 

Fever,  bilious,  from  unhealthy  house-sites 3 

puerperal,  disinfection  in 117 

in  hospitals  to  be  guarded  against 120 

scarlet 133 

disinfection  in 117 

epidemics  of,  difficulty  of  arresting         .......  133 

excreta,  importance  of  disinfecting ii^j. 

incubation,  period  of 133 

infection  from  milk 133 

infectious  agent  attaches  to  surfaces  in  room 118 

isolation  of  patients 133 

supposition  regarding  germ  of 108 

spread  by  infected  drinking-water 12 

transmission  of       ... 133 

typhoid 135 

disinfection  ir^ 119,  135 

epidemics  from  milk 135 

excreta,  disinfection  of 114 

from  impure  air 136 

unhealthy  house-sites .3 

infectious  material  should  be  destroyed  in  the  sick-room     .         .         .  108 

mental  depression  the  predisposing  cause 136 

water  infected  with,  easily  disinfected 121 

spread  through 12,  135 

ye   ow 129 

"  acclimation  " 131 

advice  regarding 125,  129 

assistants,  courageous,  called  for 124 

at  sea 121 

disinfectants  in .     116,  131 

disinfection  in 119 

of  infected  ships 123 

epidemics  of,  usually  deliberate 130 

excreta  should  be  disinfected 114 

how  contracted 129 

how  to  avoid 130 

intemperance  in  connection  with .     126,  131 

precautions  relating  to  food  and  personal  habits 130 

supposition  regarding  germ  of loS 

unsanitary  conditions  in  connection  with        .        .         .        .        .        .126 

Filth  the  pabulum  upon  which  disease-germs  thrive 102 

Fire,  apparatus  for  factories 146 

as  a  disinfectant 109 

open,  advantages  and  disadvantages  of 10 

plan  to  carry  off  smoke  in  case  of        ... 70 

precautions  against,  in  school-houses 69 

"  Fire-drill "  for  school  children 70 


1 88  INDEX. 

Fire-escapes  for  factories  --.■ 141 

the  best 70 

Fish,  per  cent,  of  water  in 33 

remarks  on   .         .         .         .     •    .         .         .        .        .        .        .         .        .        '39 

value  of,  as  a  food 39 

Floor  area  to  each  pupil 70 

fire-proofing  beneath,  recommended  in  school-houses        .         .        .         .        .       70 

kitchen • 7 

Flour,  adulteration  of 51 

and  meal,  care  of        . 5o»  51 

"patent" 51 

qualities  of  good 50 

rye,  qualities  of 50 

Flush-tanks,  how  constructed 84 

"  Fomites  " 124 

Foods  and  food-stuffs 24 

amount  required  daily  by  the  average  workingman 26 

animal 33 

classes  of 24 

definition  of 24 

economic  value  of 26 

must  not  be  left  in  living  or  sleeping  rooms 19 

nutritive  value  of 25 

rations,  daily,  cheap,  without  meat ;  analysis  and  cost 27 

with  meat ;  analysis  and  cost  .  ,  .  .  .  .28 
moderately  cheap  ;  analysis  and  cost  ....  30 
more  expensive ;  analysis  and  cost  .        .        .        •      31 

vegetable 48 

volume  of  essential 26 

Food-stuffs,  character  of       .        . 24 

Fowl,  remarks  on 39 

Fruits 57 

canned 57 

poisoning  by  decomposed 57 

value  of 57 

water  in,  amount  of     ............       25 

Fumigation  (see  sulphur  dioxide  and  sulphurous  acid  gas)         ....     117,  119 

by  sulphur 112,  117 

precautions  in 117 

Furnaces,  hot-air,  air-chambers  should  be  kept  supplied  with  water  .        .        .11 

ducts  for II,  80 

flues,  arrangement  of .11 

how  constructed ir 

registers,  position  of 11 

size  of 10 

ventilation  in  connection  with 11 

Furniture,  disinfection  of .....iiS 

G- 

Gangrene,  hospital,  to  be  guarded  against 120 

Gases  from  decomposing  matters  injurious 102 

Gelatine  culture  medium 106 

German  states,  amount  of  fresh  air  allowed  pupils  in  the 72 

Germicide,  a,  may  act  as  an  antiseptic 108 

Germs,  decomposition  due  to 102 

disease,  in  the  sick-room .        •  ^^Z 


INDEX.  189 

Germs,  disease,  many  now  known  to  us 106 

may  be  produced  in  culture  fluids .  106 

not  charmed  away 105 

filth  the  pabulum  upon  which  they  thrive 102 

the  infectious  agent  of  many  diseases 105 

Girls,  sickly,  in  school-room 93 

Glucose ^6 

Goitre  possibly  produced  by  drinking  hard  water 14 

Grains  and  cereals •  ...  48 

Grate,  at  least  one  bed-room  should  contain  a 6 

Gravel  caused  by  drinking  hard  water 14 

Grindstones  in  factories  should  be  covered 150 

Gymnastics  and  school-desks 92 

how  exereised  in  school-room <■  94 

obstacles  that  prevent,  in  schools '94 

H 

Halls  for  tenement-houses .  22 

should  be  placed  on  the  side  of  the  house  having  the  least  sunlight         .         .6 

space  saved  by  doing  away  with 6 

Ham,  pork,  and  bacon          ............  38 

Hand-grenades  not  to  be  depended  upon 146 

Handkerchiefs,  how  to  disinfect 115 

Health,  sunlight  essential  to •       .        .  143 

Healthy  foods 24 

Heating  and  ventilation 7)  72 

"  indirect " 78 

methods  of 8 

of  factories 144 

Height  of  school-buildings 71 

Hog,  value  of,  as  an  article  of  food 38 

Home,  building  a 3 

care  of ig 

location  of 3 

surroundings  of 18 

Honey 56 

Hospitals,  disinfection,  and  other  precautions  against  disease 120 

House,  buying  or  renting  a 19 

directions  for  inspection  of  a 20 

floors  of,  how  made 5 

new  brick  should  not  be  occupied  immediately 5 

should  always  have  a  cellar 4 

site,  best  soil  for 4 

should  be  drained 3 

tenement 22 

Hygiene  of  the  eye 88 

school ....  65 

I 

Ice,  dangers  from 147 

Individual  prophylaxis  against  infectious  diseases 124 

Infants,  preparation  of  cows'  milk  for 45 

Injuries  in  workshops 151 

Instruments,  surgical,  disinfection  of  .         . 120 

Intemperance  and  the  workingman 150 

in  pestilential  diseases 126 


IQO  INDEX.  ^ 

Iron,  drinking-water  should  not  contain  more  than  one  tenth  of  one  per  cent,  of      .       14 

sulphate  of,  an  antiseptic loi 

special  uses .        1        .        .        .        .119 


K 

Kedzie,  Prof.,  on  amount  of  air  required  for  pupils 


Kitchen  in  basement  undesirable  *...... 

the  most  important  room  in  the  house    .... 

to  be  kept  in  good  order,  must  be  properly  constructed 
windows,  there  should  be  at  least  two  on  each  side 

Kohn  on  the  eyes  of  school-children    .... 

L 


72 
4 

7 

7 

7 


Labarraque's  solution  as  a  disinfectant no 

special  uses  of 115 

Lamb,  easy  of  digestion 38 

Lange's  method  of  testing  for  carbonic  acid 80 

Latrines,  how  constructed 84 

Lemonade,  sulphuric  acid,  in  cholera  .        .         .         .         , 129 

Lenses  may  produce  fire 145 

Light,  bad,  cause  of  near-sightedness 89 

how  it  should  be  admitted  to  the  school-room 92 

in  factories 143 

not  sufficient  on  a  restricted  site 66 

the  best  for  school-rooms 91 

the  most  essential  thing  in  a  public  school 66 

Lights  in  factories 144 

Lightning-rods 143 

Lime,  chloride  of,  as  a  disinfectant no 

for  the  sick-room 114 

how  prepared  for  the  disinfection  of  vaults 120 

special  uses  of 1 15,  1 18,  119,  120 

Littre's  definition  of  disinfection 103 

Lobster,  value  of  ..............  40 

M 

Machinery  tends  to  dwarf  the  intellect         .        .        .        .        .        .        .        .        .153 

Mails,  disinfection  of ,  ,        .        .        ,  123 

Malaria  from  unhealthy  house  sites 3 

Martin,  A.  C,  on  amount  of  air  required  for  pupils .  72 

Meal,  adulteration  of .51 

and  flour,  care  of .         S^t  'ii^ 

Measles 136 

Meat,  constituents  of •        •        •  33 

degree  of  digestibility 34 

differs  at  different  seasons 34 

diseased,  produces  disease         • 35 

effect  of  rigor  mortis  ............35 

extracts 40 

fluid  and  peptones 41 

general  properties  of 33 

heat  necessary  to  destroy  parasites    .        .                35 

how  effected  by  slaughtering 35 

how  to  boil 36 


INDEX.  191 

Meat,  how  to  roast 36 

in  common  use 37 

knowledge  possessed  by  the  ancients 35 

list  of,  which  should  not  be  eaten •     .         -36 

methods  of  cooking 36 

parasites  of,  conveyed  to  man    . 35 

partially  decomposed,  may  be  poisonous 36 

rules  to  govern  the  selection  of           .........  34 

some  fat  desirable  in 35 

stewed 36 

water,  amount  of,  in 25,  33 

Mechanics,  exposed  to  lung  disease 139 

the  lives  of,  not  what  they  should  be 139 

Medical  attendance,  the  best,  difficult  for  mechanics  to  obtain 151 

officer  and  school  officer  combined 97 

Melons 55 

Merchandise,  disinfection  of 123 

Mercuric  chloride,  amount  required  to  disinfect  vaults 120 

as  a  disinfectant .11 

as  an  antiseptic ,iir 

destructive  to  spores in 

special  uses  of 115,  116,  118,  119,  120 

Mercury,  bi-chloride  of,  as  a  disinfectant      .         .         •        .         .         .        .        .        .111 

Micrococci 107 

pathogenic,  destroyed  by  carbolic  acid        o 113 

Milk 41 

absorbs  gases         .............  42 

adulteration  of 43 

amount  required  to  support  life 45 

average  amount  of  water  in          ..........  25 

"  barnyard  " 44 

"bitter-sweet" 44 

"blue" 44 

care  of  the 42 

composition  of 41 

condensed,  how  prepared 45 

cows',  preparation  of,  for  infants 45 

diseased 44 

germs  of  disease  distributed  in 42 

kinds  that  should  be  avoided 44 

methods  of  adulteration        . 43 

precautions  regarding  use  during  epidemics 121 

scarlet  fever  conveyed  in 133 

sickness,  cause  not  recognized 44 

'slimy" 44 

souring  of 42 

sugar 42 

value  of,  as  a  food 45 

watering,  may  be  a  criminal  act 43 

Mineral  matter  contained  in  bones 25 

in  muscles,  blood,  etc. -25 

salts           .         .      - 25 

Molasses  and  syrups -  S6 

Moulding-machines,  dangerous     .        . .150 

Mustards,  how  adulterated 59 

Mutton,  general  remarks  on 38 

Myopia 88 


192  INDEX.  f 

N 

Napkins,  how  to  disinfect 115 

Naphtha,  dangers  from 146 

Near-sightedness,  chief  causes  of 89 

disadvantages  of 89 

percentage  of,  in  different  nationalities 88 

sometimes  inherited         , 88 

Nerjjous  system,  affections  of  the 94 

Nichols,  Prof.  W.  R.,  on  carbonic  gas  in  schools 79 

Nuts,  composition  of 58 

o 

Oatmeal,  composition  of 49 

qualities  of 51 

Odors,  bad,  should  arouse  suspicion    ..........  103 

Oils,  etc.,  should  be  kept  in  a  fire-proof  building 145 

vegetable 58 

Oleomargarine  and  butterine 46 

Organisms,  micro,  difference  in  resisting  powers  of 107 

Overwork  in  the  school-room 94 

•  Oysters,  nutritive  value  of 40 

Pantry  or  shelves  should  be  provide- 7 

Parkes  and  DeChaumont,  on  amount  of  fresh  air  required  in  school-rooms        .         ,  73 

Parlor,  how  regarded 6 

Parsnips ^4 

Pea  sausage 40 

Pease  and  beans 53 

composition  of 53 

food  value  of 54 

soft,  green,  easily  digested 53 

Pepper,  how  adulterated 59 

Peptones  and  fluid  meats 41 

Personal  cleanliness  among  mechanics 152 

Person,  disinfection  of  the 115 

Persons,  susceptible,  do  not  always  contract  disease 104 

Pipes  and  tanks,  lead-lined,  should  not  be  used  for  conveying  or  storing  cistern- 
water        IC 

Pipes,  water,  should  be  of  iron,  block-tin,  or  lined  with  tin 15 

waste,  how  arranged   ............  84 

Plastering,  how  put  on  stone  or  brick e 

Poisons,  persons  working  over,  should  talk  but  little 152 

should  be  carefully  labelled 153 

Police,  sanitary,  general  object  of 108 

Pork,  bacon,  and  ham 38 

"  measly,"  description  of 39 

rules  governing  the  selection  of           ...                 34 

Potatoes,  composition  of 54 

Privies,  disinfectants  for 87 

school-house 85, 87 

cause  of  disease  among  pupils 83 

faults  of 85 

should  be  separate  for  the  sexes 86 

special  dangers  from 86 


INDEX.  193 

Privy  vaults,  amount  of  mercuric  chloride  required  to  disinfect 120 

dangerous  to  health 17 

disinfection  of 17,  119 

how  disinfected  with  chloride  of  lime 120 

Prophylaxis,  general  rule  of 124 

Proteids,  conversion  of 25 

or  albumens 24 

Phthisis  (see  Tuberculosis  and  Consumption). 

Ptomaines  a  product  of  putrefaction 102 

Pulleys,  loose,  dangers  from 150 

Pumpkins 55 

Q 

Quarantine  establishments,  disinfection  at .122 

Race  susceptibility  to  disease 126 

Rags,  disinfection  of 123 

oiled,  liable  to  spontaneous  combustion 145 

transmission  of  disease  by 123 

Railroading,  accidents  in 150 

Registers,  hot-air 143 

in  ventilating  flues,  where  placed 9 

size  of   .         .         .         . 74 

Residences,  how  built .18 

Rhubarb 55 

Rice,  composition  of              49 

Roofs  should  be  provided  with  fenders  to  break  snow  and  ice 143 

Rooms,  arrangement  of \        .         .  6 

living  should  be  sunny  and  airy .  6 

recitation,  deficiency  in  size 68 

Rules  for  factories 153 

Rye,  composition  of 49 

s 

Sago 55 

Salt,  value  of „ 58 

Sanitary  supervision  of  schools 97 

Sausage,  adulteration  of 40 

poisoning 40 

remarks  on 40 

Saws,  danger  from 148 

different  kinds  of         .         .        .        , .  149 

Scarlet  fever  (see  Fever,  scarlet). 

Scholars,  grievances  of 95 

School  architecture,  greatly  improved  within  a  few  years 67 

boards,  responsibility  of 93- 

buildings,  height  of .        .        .        •  ^^ 

in  New  York .  67 

plan  and  arrangement  of          .........  67 

children,  German,  work  harder  than  American .88 

harm  from  social  dissipation      .        .                 95 

class-room,  height  of         ...........  71 

desks  and  gymnastics 92 

fatigue,  results  of 95 

School-house,  city,  desirable  qualifications  of 70 


194  INDEX. 

School-house,  four-square  plan  of        , 69 

precautions  against  fire  in 69 

without  cellar,  should  have  air  space  beneath  floor      ....  66 

School  hygiene,  division  of  subjects 65 

officer  and  medical  officer  combined 97 

prizes  bad 94 

room,  excessive  height  a  fault 68 

lack  of  space  a  fault 67 

large,  with  insufficient  light 68 

the  separate  entrances  (illustration) 86 

temperature  of 71 

large,  twofold  advantage  of 72 

ventilation  of 71 

sessions,  time  of 94 

Schools,  contagious  diseases  in 96 

medical  supervision  of 97 

regulations  to  prevent  the  spread  of  contagious  diseases       ....  96 

sanitary  supervision  of 97 

should  be  removed  from  noise 66 

Seats  for  school-children 92 

for  factories 148 

Septicaemia  to  be  guarded  against  in  hospitals 120 

Sewerage 83 

"  separate  system  "  of,  so  called 15 

Sewers,  cause  disease  among  school-children       ........  83 

grade  and  position  of 21 

Ships,  disinfection  of 121 

by  steam 123 

should  be  performed  by  a  sanitary  expert  .         .         .         .123 

how  '<.o  disinfect  the  bilge 123 

how  to  treat  an  infected  one  in  port 123 

Sick-room,  daily  care  of 118 

disinfection  of n8 

should  be  full  of  cheer 6 

Sink-traps 84 

Site  of  school-house 65 

dampness  of 66 

underground  water  provided  for  in 66 

Skin,  contagious  affections  of,  excluded  from  schools  .         .         .         .         .         -97 

diseases 136 

Small-pox 131 

avoidance  of 132 

disinfection  in 116 

how  contracted 131 

infectious  agent  attaches  to  surfaces  of  room 118 

principle  of  ... 132 

isolation  of  patients 132 

the  result  of  personal  habits 132 

"respirator"  in,  the 132 

statistics  of,  among  the  unvaccinated 132 

supposition  regarding  germ  of 108 

vaccination  the  prophylactic 132 

Soil-pipe,  construction  of .16 

Soil,  ventilation  of 21 

Soup,  how  to  make 36 

Spinach 54 

Spine,  deformity  of 65 


INDEX.  195 

Spittoons  with  sawdust,  the  cause  of  fire .  145 

Sponges,  disinfection  of 120 

Spores,  certain  species  withstand  a  boiling  temperature 107 

description  of   ............         .  107 

destruction  of,  a  test  of  disinfecting  power 116 

not  destro^'cd  by  sulphur  dioxide 117 

power  to  resist  heat  and  disinfectants      .         .         .         .         .         .         .         .107 

Sprinklers,  automatic,  in  factories,  a  protection  against  fire 146 

Sputum,  how  disinfected 115 

Squash 55 

Stairs,  bad  effects  of 95 

spiral,  objectionable .  69 

Stairways  should  be  fire-proof 69 

Starches 55 

amount  required  per  day -25 

and  carbo-hydrates 25 

Steam,  disinfection  of  clothing  with 116 

heating,  one  of  the  best  methods '       ,         .         .81 

pipes,  care  of 144 

under  pressure  as  a  disinfectant ,110 

Stoves,  advantages  of  coal 8 

of  wood  . 8 

and  furnaces,  care  should  be  used  in  the  construction  of         ....  8 

cast-iron,  emitting  carbonic  acid  gas,  belief  not  sustained        ....  83 

how  arranged  in  factories 144 

should  be  covered  with  a  hood 7 

ventilating 81 

Study,  under  certain  conditions,  cause  of  near-sightedness 89 

Sugars   .         .     ^ 55 

adulteration  of  .         .         . 56 

quality  of    .... •         •  55 

Sulphur,  amount  necessary  in  fumigation 117 

dioxide,  disinfection  with       .         .         .         .         .         .         .        .         .         .112 

precautions  in  fumigation  with ri7 

Sulphurous  acid  gas  (sulphur  dioxide),  disinfection  with     ....      112,116,117 

in  the  disinfection  of  ships 123 

not  destructive  to  spores .  107 

Sunlight  as  a  contributor  to  health 143 

should  not  be  excluded  .     ' •  6,  7 

Syrups  and  molasses 56 

T 

Tannin  in  tea o        .        ,         ....  60 

Tapioca 55 

Tea  a  stimulant 59 

how  adulterated 61 

how  prepared  for  drinking 60 

increases  waste  of  tissue 59 

kinds  of  ..........         t         ....  60 

when  to  be  used 60 

Teachers,  grievances  of         .         .         .         .         .         .         .         .        ...         -95 

lack  of  exercise  among 95 

Theine 60 

The  preventable  causes  of  disease,  injury,  and  death  in  American  manufactories  and 

work-shops,  and  the  best  means  and  appliances  for  avoiding  them           .        .  139 

Tomatoes 55 


196  INDEX. 

Tools,  how  to  leave f-^0 

Towels,  how  to  disinfect ...•«••  115 

Traps  for  sinks .....•••  84 

how  placed 16 

ventilation  of 84 

Trees  frequently  beneficial 18 

Trichinae 39 

destroyed  at  160  degrees  Fahr 39 

Trucks  for  handling  goods,  how  constructed 148 

Tuberculosis 35 

advice  to  those  having  a  hereditary  predisposition  to    .        .        .        '135 

an  infectious  disease 135 

caused  by  the  inhalation  of  dust 13S 

difference  in  susceptibility  to 135 

important  to  disinfect  excreta  in .        .114 

Turnips  and  turnip-tops •••••54 

Typhoid  fever  (see  Fever,  typhoid). 

u 

Urinals,  how  constructed      .        .        ..• .        .  8j 

V 

Vaccination 132 

should  be  enforced  among  school-children 97 

Vaccine  virus  destroyed  by  disinfectants 106 

destroyed  by  sulphurous  acid  gas II2 

Vallin  on  disinfection  and  disinfectants 103 

Vaults,  how  cared  for 17 

Veal,  digestion  of,  difficult 38 

general  character  of     .... 37 

rules  governing  the  selection  of 34 

Vegetables 54 

amount  of  water  in ...•••  25 

decaying,  must  not  be  left  in  the  cellar 19 

foods 48 

Ventilating  apparatus,  dimensions  of 74 

by  steam  power 77 

devices  for  windows   .         , 8 

flues  should  have  air-tight  joints 10 

should  be  one  for  each  room 12 

Ventilating-stoves • 81 

Ventilation  and  heating 7>  72 

by  means  of  flues        .        .                9 

by  means  of  tube  terminating  in  stove-jacket 9 

good,  a  low  temperature  more  comfortable  with  than  without         .        .  78 

what  it  implies 78 

in  connection  with  hot-air  furnaces Ii 

stoves 8 

in  factories          ...                142 

m              in  school-rooms 71 

methods  of 75 

of  tenement-houses 23 

of  traps 84 

system  used  in  the  Massachusetts  Institute  of  Technology      ...  78 

Ventilator,  open  fire  an  excellent 6 

the  "  Eureka  " 83 


INDEX.  197 

Vinegar,  composition  of 59 

varieties  of      .............  ^g 

Virchow  on  "  School  Diseases  " 65 

Wall-papers,  economy  of 5 

frequently  contain  arsenic 5 

Walls,  tints  of,  for  school-room 92 

Waring,  Col.,  method  of  constructing  damp-proof  floor 66 

Waste,  disposal  of         .         . 15 

kitchen,  how  disposed  of 18 

pipes  should  be  well  trapped .  17 

Water  absorbed  by  brick 5 

cistern,  defined 12 

how  contaminated .         .         .         .12 

filters  for 13 

lead  pipes  or  lead-lined  storage-tanks  should  not  be  used    .         .         .  \\ 

containing  disease-germs  easily  disinfected 121 

disinfection  of 121 

drinking,  should  not  contain  more  than  one  tenth  of  one  per  cent. 

of  iron 14 

sources  of    .         . 12 

evaporation  of,  in  connection  with  heaters 82 

hard,  classification  of 14 

diseases  caused  by 14 

hardness  of,  due  to  inorganic  salts 14 

impure,  diseases  spread  by 12 

per  cent.,  in  adult  body           .                 25 

pipes,  discharge,  how  constructed  in  tenement-houses           ...  22 

public  supply,  health  authorities  should  see  that  it  is  pure          .         ,  15 

subterranean,  often  hard 14 

surface,  should  be  boiled  in  times  of  epidemics 13 

the  purity  of,  dependent  upon  the  soil  and  air        ...  13 

typhoid  fever  and  dysentery  spread  by 13 

to  what  extent  purified  by  filtering  through  the  soil     ....  14 

Water-closets,  amount  of  water  required  in 22 

dangers  from 142 

for  schools 7i>  84 

hopper,  arrangement  of 16 

how  arranged 142 

how  cared  for  in  tenement-houses 22 

Wells,  deep,  should  have  their  walls  protected  against  surface-water         ...  14 

in  village  or  city  should  be  avoided 135 

shallow 14 

Wheat,  composition  of 48 

Whooping-cough 136 

important  to  disinfect  excreta  in 114 

Windows,  cellar,  how  arranged    .         .         .         .         - 4 

draughts  from,  the  cause  of  sickness 143 

should  be  at  least  two  on  each  side  of  the  kitchen 71 

light  from,  in  school-rooms ,        .        .91 

opening,  regarded  in  two  lights 82 

position  of,  and  how  hung  ..........  7 

space  to  school-room 71 

Worms,  tape,  developed  from  cysticerci 39 

Wounds,  importance  of  antiseptic  treatment  in 120 


198  INDEX. 

Y 

Yards,  cleanliness  of 18 

factory,  should  be  kept  clean  of  rubbish 145 

Yeast,  composition  of 51 

Yellow  fever  (see  Fever,  yellow). 

z 

Zinc,  chloride  of,  as  a  disinfectant 113 

in  cholera ' 115 

over-estimated  as  a  disinfectant 113 


The  Lomb  Drtze  l$$ 


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